{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T23:17:58Z","timestamp":1765840678018,"version":"3.48.0"},"reference-count":17,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T00:00:00Z","timestamp":1698883200000},"content-version":"unspecified","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Allergic Rhinitis","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,10,3]]},"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Intranasal antihistamines and corticosteroids are some of the most frequently used drug classes in the treatment of allergic rhinitis. However, there is uncertainty as to whether effectiveness differences may exist among different intranasal specific medications. This systematic review aims to analyse and synthesise all evidence from randomised controlled trials (RCTs) on the effectiveness of intranasal antihistamines and corticosteroids in rhinitis nasal and ocular symptoms and in rhinoconjunctivitis-related quality-of-life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>We will search four electronic bibliographic databases and three clinical trials databases for RCTs (1) assessing patients \u226512 years old with seasonal or perennial allergic rhinitis and (2) comparing the use of intranasal antihistamines or corticosteroids versus placebo. Assessed outcomes will include the Total Nasal Symptom Score (TNSS), the Total Ocular Symptom Score (TOSS) and the Rhinoconjunctivitis Quality-of-Life Questionnaire (RQLQ). We will assess the methodological quality of included primary studies by using the Cochrane risk-of-bias tool. Certainty in the body of evidence for the analysed outcomes will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. We will perform a random-effects meta-analysis for each assessed medication and outcome, presenting results as pooled mean differences and standardised mean differences. Heterogeneity will be explored by sensitivity and subgroup analyses, considering (1) the risk of bias, (2) the follow-up period and (3) the drug dose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical considerations will not be required. Results will be disseminated in a peer-review journal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42023416573.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-076614","type":"journal-article","created":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T13:31:36Z","timestamp":1698931896000},"page":"e076614","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Intranasal antihistamines and corticosteroids in the treatment of allergic rhinitis: a systematic review and meta-analysis protocol"],"prefix":"10.1136","volume":"13","author":[{"given":"Bernardo","family":"Sousa-Pinto","sequence":"first","affiliation":[{"name":"MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"CINTESIS@RISE - Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"given":"Rafael Jos\u00e9","family":"Vieira","sequence":"additional","affiliation":[{"name":"MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"CINTESIS@RISE - Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"given":"Jan","family":"Brozek","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence and Impact & Department of Medicine, McMaster University, Hamilton, Ontario, Canada"}]},{"given":"Ant\u00f3nio","family":"Cardoso-Fernandes","sequence":"additional","affiliation":[{"name":"MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"CINTESIS@RISE - Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"given":"Nuno","family":"Louren\u00e7o-Silva","sequence":"additional","affiliation":[{"name":"MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"CINTESIS@RISE - Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"given":"Renato","family":"Ferreira-da-Silva","sequence":"additional","affiliation":[{"name":"MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"CINTESIS@RISE - Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"given":"Andr\u00e9","family":"Ferreira","sequence":"additional","affiliation":[{"name":"CINTESIS@RISE - Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"Department of Ophthalmology, Centro Hospitalar Universit\u00e1rio do Porto, Porto, Portugal"}]},{"given":"Sara","family":"Gil-Mata","sequence":"additional","affiliation":[{"name":"MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"CINTESIS@RISE - Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"given":"Anna","family":"Bedbrook","sequence":"additional","affiliation":[{"name":"MASK-air, Montpellier, France"}]},{"given":"Ludger","family":"Klimek","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, Universit\u00e4tsmedizin Mainz, Mainz, Germany"},{"name":"Center for Rhinology and Allergology, Wiesbaden, Germany"}]},{"given":"Joao A","family":"Fonseca","sequence":"additional","affiliation":[{"name":"MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"CINTESIS@RISE - Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"given":"Torsten","family":"Zuberbier","sequence":"additional","affiliation":[{"name":"Institute of Allergology, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Berlin, Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3211-8479","authenticated-orcid":false,"given":"Holger J","family":"Sch\u00fcnemann","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence and Impact & Department of Medicine, 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