{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T11:03:33Z","timestamp":1776683013310,"version":"3.51.2"},"reference-count":0,"publisher":"Publicacoes Ciencia e Vida, Lda","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["rpia"],"published-print":{"date-parts":[[2025,9,30]]},"abstract":"<jats:p>Background: In patients with allergic rhinitis who remain uncontrolled despite being treated with standard\ndaily doses of a single medication, strategies that can be followed to achieve adequate symptom control include (i)\nincreasing the medication dose, or (ii) adding an additional medication (co-medication). However, it is not known\nwhich one of these two strategies is more effective. Objectives: This article describes a protocol of a systematic\nreview with dose-response network meta-analysis aiming at comparing different intranasal and oral medications in\npatients with seasonal or perennial allergic rhinitis. Methods: We will search four electronic bibliographic databases and three clinical trials databases for randomized controlled trials (i) assessing adults or children with seasonal or perennial allergic rhinitis, and (ii) evaluating the effect of intranasal medications, oral medications or\ncombinations of any intranasal and\/or oral medications for allergic rhinitis. Assessed outcomes will include the\nTotal Nasal Symptom Score, the Total Ocular Symptom Score and the Rhinoconjunctivitis Quality-of-Life Questionnaire (RQLQ). We will assess the methodological quality of included primary studies by using the Cochrane riskof-bias tool. Certainty in the body of evidence for the analysed outcomes will be assessed using the Grading of\nRecommendations Assessment, Development and Evaluation approach for network meta-analyses (GRADE-NMA).\nWe will perform a frequentist dose-response model-based network meta-analysis. Sensitivity analyses will be performed by separately analysing data for seasonal and perennial allergic rhinitis. Conclusion: This protocol describes\nthe methodology of a systematic review that will fit dose-response network meta-analysis models in the comparison between different intranasal and oral medications. The findings of this systematic review will support recommendations in the Allergic Rhinitis and its Impact on Asthma (ARIA) 2024-2025 guidelines.<\/jats:p>","DOI":"10.32932\/rpia.2025.09.171","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T10:19:26Z","timestamp":1776680366000},"page":"29-37","source":"Crossref","is-referenced-by-count":0,"title":["Treatment dose increase versus comedication in allergic rhinitis: Systematic review with dose-response network meta-analysis protocol"],"prefix":"10.32932","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1277-3401","authenticated-orcid":false,"given":"Bernardo","family":"Sousa-Pinto","sequence":"first","affiliation":[{"name":"MEDCIDS \u2013 Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1834-3055","authenticated-orcid":false,"given":"Rafael","family":"Vieira","sequence":"additional","affiliation":[{"name":"MEDCIDS \u2013 Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9564-3652","authenticated-orcid":false,"given":"Sara","family":"Gil-Mata","sequence":"additional","affiliation":[{"name":"MEDCIDS \u2013 Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5468-0932","authenticated-orcid":false,"given":"Ana","family":"Pereira","sequence":"additional","affiliation":[{"name":"MEDCIDS \u2013 Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6731-5836","authenticated-orcid":false,"given":"V\u00edtor","family":"Duarte","sequence":"additional","affiliation":[{"name":"MEDCIDS \u2013 Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0128-903X","authenticated-orcid":false,"given":"Antonio","family":"Bognanni","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Research Center (CERC), IRCCS Humanitas Research Hospital & Department of Biomedical Sciences, Humanitas University, Milan, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9827-2551","authenticated-orcid":false,"given":"Manuel","family":"Marques-Cruz","sequence":"additional","affiliation":[{"name":"MEDCIDS \u2013 Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5962-4043","authenticated-orcid":false,"given":"Pawe\u0142","family":"Jemio\u0142o","sequence":"additional","affiliation":[{"name":"AGH University of Krakow, Krak\u00f3w, Poland"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1466-8875","authenticated-orcid":false,"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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0201-2630","authenticated-orcid":false,"given":"Alexandro","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3211-8479","authenticated-orcid":false,"given":"Holger","family":"Sch\u00fcnemann","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Research Center (CERC), IRCCS Humanitas Research Hospital & Department of Biomedical Sciences, Humanitas University, Milan, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6214-9087","authenticated-orcid":false,"given":"Guido","family":"Schwarzer","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Medical Center \u2013 University of Freiburg, Institute of Medical Biometry and Statistics, Freiburg, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0887-8796","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Fonseca","sequence":"additional","affiliation":[{"name":"MEDCIDS \u2013 Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4061-4766","authenticated-orcid":false,"given":"Jean","family":"Bousquet","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"}]}],"member":"18270","published-online":{"date-parts":[[2025,9,30]]},"container-title":["Revista Portuguesa de Imunoalergologia"],"original-title":[],"deposited":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T10:19:28Z","timestamp":1776680368000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.spaic.pt\/client_files\/rpia_artigos\/pgina-educacional(19).pdf"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,30]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,9,30]]},"published-print":{"date-parts":[[2025,9,30]]}},"URL":"https:\/\/doi.org\/10.32932\/rpia.2025.09.171","relation":{},"ISSN":["0871-9721","2184-3856"],"issn-type":[{"value":"0871-9721","type":"print"},{"value":"2184-3856","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,30]]}}}