In a recent network meta-analysis conducted to assess the effectiveness and patient acceptance of licensed dose aqueous intranasal corticosteroids (INCS) for treating moderate-to-severe allergic rhinitis (AR), Mometasone furoate (MF) stood out as the most effective therapeutic option for seasonal allergic rhinitis (SAR), whereas Budesonide demonstrated its highest efficacy in addressing perennial allergic rhinitis (PAR).

The study, which incorporated a comprehensive search of Cochrane Central Register of Controlled Trials, EMBASE, Scopus, and PubMed/MEDLINE, specifically focused on trials comparing INCSs to placebos or other INCSs in AR-affected people. The research involved 26 studies, with 13 focusing on 5,134 patients suffering from SAR and another 13 including 4,393 patients with PAR.

The majority of the placebo-controlled trials were determined to have a moderate evidence quality. In the case of seasonal AR, MF emerged as the most efficacious INCS. This was closely followed by Fluticasone furoate (FF), Ciclesonide (CIC), Fluticasone propionate, and Triamcinolone acetonide (TAA), with standardized mean differences (SMD) ranging from -0.47 to -0.41. For perennial AR, Budesonide was identified as the most efficacious INCS, with FF, TAA, CIC, and MF following closely behind, with SMDs between -0.43 and -0.28.

The acceptability of all encompassed INCSs showed non-inferiority to the placebo. In conclusion, the study suggests that, based on indirect comparisons, few INCSs exhibit superior effectiveness to others when managing AR, though the quality of evidence in the majority of the placebo-controlled studies was deemed moderate.