Evidence map›Paper›PMID 42596864›Full record

SynthesisPediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology2026

Efficacy and safety of oral treatments for allergic rhinitis in children: A network meta-analysis.

Tuuli Thomander, Sara Gil-Mata, Pau Riera-Serra, Rafael José Vieira, André Ferreira, Antonio Bognanni, Vítor Henrique Duarte, Hugo Viegas, Ana Margarida Pereira, Renato Ferreira-da-Silva and 32 more

Abstract readNetwork Meta-AnalysisSystematic Review
In one paragraph

Synthesis in Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Efficacy and safety of oral treatments for allergic rhinitis in children: A network meta-analysis.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2026
    Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

42 authors.

Tuuli ThomanderMEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Sara Gil-MataMEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Pau Riera-SerraCINTESIS@RISE, Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal.
Rafael José VieiraMEDCIDS, 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
André FerreiraCINTESIS@RISE, Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal.
Antonio BognanniClinical Epidemiology and Research Center (CERC), Humanitas University and Humanitas Research Hospital, Milan, Italy.ORCID https://orcid.org/0000-0003-0128-903X
Vítor Henrique DuarteMEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Hugo ViegasMEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Ana Margarida PereiraMEDCIDS, 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
Renato Ferreira-da-SilvaMEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.ORCID https://orcid.org/0000-0001-6517-6021
Henrique Ferreira-CardosoMEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Manuel Marques-CruzMEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
João Castro-TelesMEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Miguel Campos-LopesMEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.ORCID https://orcid.org/0000-0002-7112-3580
Ana Teixeira FerreiraMEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Nuno Lourenço-SilvaMEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.ORCID https://orcid.org/0000-0001-8133-4667
José Laerte BoechatMEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Ewa BorowiackEvidence Prime, Hamilton, Ontario, Canada.ORCID https://orcid.org/0009-0004-9666-5425
Ewelina SadowskaEvidence Prime, Hamilton, Ontario, Canada.ORCID https://orcid.org/0000-0001-8585-4109
Raquel Albuquerque CostaMEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Paula PerestreloMEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.ORCID https://orcid.org/0000-0002-7298-7858
Juliana Pereira-MacedoMEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.ORCID https://orcid.org/0000-0001-9271-0277
Despo IerodiakonouDepartment of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus.ORCID https://orcid.org/0000-0002-7862-2016
Alexandro W L ChuDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Izabela Pera CalviMEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Maria Inês TorresMEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Rita Silva RibeiroMEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Ivan Chérrez-OjedaUniversidad Espíritu Santo, Samborondón, Ecuador.ORCID https://orcid.org/0000-0002-1610-239X
Juan Jose Yepes NuñezSchool of Medicine, Universidad de los Andes, Bogotá, DC, Colombia.
Torsten ZuberbierInstitute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0002-1466-8875
Ricardo M FernandesClinical Pharmacology and Therapeutics, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
Alessandro FiocchiAllergy Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.ORCID https://orcid.org/0000-0002-2549-0523
Désirée E Larenas-LinnemannCenter of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico.ORCID https://orcid.org/0000-0002-5713-5331
Nhân Pham-ThiEcole Polytechnique de Palaiseau, Palaiseau, France.
Nikolaos G PapadopoulosAllergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
Graham RobertsFaculty of Medicine, University of Southampton, Southampton, UK.ORCID https://orcid.org/0000-0003-2252-1248
Arunas ValiulisInterdisciplinary Research Group of Human Ecology, Institute of Clinical Medicine and Institute of Health Sciences, Medical Faculty of Vilnius University, Vilnius, Lithuania.
João A FonsecaMEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
Holger J SchünemannClinical Epidemiology and Research Center (CERC), Humanitas University and Humanitas Research Hospital, Milan, Italy.ORCID https://orcid.org/0000-0003-3211-8479
Mattia GiovanniniAllergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy.ORCID https://orcid.org/0000-0001-9568-6882
Bernardo Sousa-PintoMEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.ORCID https://orcid.org/0000-0002-1277-3401
ARIA 2024–2025 guideline panel

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAllergic rhinitis is the most common chronic disease in children. Information on efficacy and safety of oral allergic rhinitis treatments in children is scarce. We aimed to comprehensively evaluate the efficacy and safety of oral medications for allergic rhinitis in children.

methodsWe performed a systematic review, searching three bibliographic databases and clinicaltrials.gov for randomized controlled trials assessing the use of oral antihistamines (OAH) or leukotriene receptor antagonists (LTRA) in children (<12 years old) with seasonal or perennial allergic rhinitis. Evaluated outcomes included the Total Nasal Symptom Score (TNSS), the Total Ocular Symptom Score (TOSS), the Rhinoconjunctivitis Quality-of-Life Questionnaire (RQLQ), development of adverse or serious adverse events, and withdrawals due to adverse events. We performed network meta-analysis at both class and individual treatment levels. Certainty in the body of evidence was assessed using the GRADE approach for network meta-analysis.

resultsWe included eight primary studies with 906 participants. Overall, OAH were more effective against placebo in improving the TNSS (mean difference (MD) = -1.60; 95%CI = -2.25 to -0.95). On the other hand, OAH+LTRA did not demonstrate additional benefit over OAH in improving the TNSS (MD = -0.15; 95% CI = -1.18 to 0.88), and there were no important differences between individual OAH. Evidence on the TOSS was not found. No significant differences in the frequency of adverse events were observed. Certainty of evidence was low or very low for most comparisons.

conclusionsOral treatments for allergic rhinitis appear to be effective and safe in children. However, evidence is scarce and the quality of evidence is mostly low. We performed a systematic review of randomised controlled trials assessing oral medications for allergic rhinitis in children and reporting results on nasal symptoms, ocular symptoms, quality of life and adverse events. Oral antihistamines (OAH) were found to be better than placebo, and OAH + oral leukotriene receptor antagonists (OLTRA) were not found to be better than OAH. We identified trivial differences between different OAH.

Indexed as

Anti-Allergic AgentsHistamine AntagonistsLeukotriene AntagonistsRhinitis, AllergicAdministration, OralChildChild, PreschoolHumansQuality of LifeRandomized Controlled Trials as TopicTreatment OutcomeAnti-Allergic AgentsHistamine AntagonistsLeukotriene Antagonistsallergic rhinitischildrenleukotriene receptor antagonistsnetwork meta‐analysisoral antihistaminesquality of lifesystematic review

Identifiers

PMID42596864
PMCPMC13474117

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.