Ipratropium Bromide Nasal Spray in Non‐Allergic Rhinitis: A Systematic Review and Meta‐Analysis

Objective This study aims to compare the effectiveness of intranasal ipratropium bromide (INIB) to a placebo in reducing nasal symptoms, particularly rhinorrhea, and enhancing quality of life in non‐allergic rhinitis (NAR) patients. Study Design Systematic review and meta‐analysis. Methods A comprehensive review of the literature was conducted on Medline, Embase, and Cochrane libraries. Randomized controlled trials (RCTs) and non‐randomized comparative parallel group trials comparing IB nasal spray to placebo were included. Results Five RCTs assessed a total of 472 participants with a diagnosis of NAR. IB nasal spray 0.03% were used across all studies. IB has a better impact on decreasing rhinorrhea than the placebo, with a standardized mean difference (SMD) of 0.93 (95% CI 0.06–1.8). The mean change in rhinorrhea severity was 85% (95% CI 77–92%) and I^2 26% ( p = 0.24). IB outperformed the placebo in terms of shortening the symptom's duration/day, as shown by an SMD of 0.35 (95% CI 0.15–0.55). The difference between treatments was noticeable within the first week and remained consistent throughout the treatment. Patients who were administered IB experienced a substantially greater improvement in physical and mental outcomes. Nasal adverse events with IB were generally intermittent and brief. Conclusion Compared with a placebo, IB nasal spray is both safe and effective in treating the rhinorrhea associated with NAR. IB significantly reduces the severity and duration of rhinorrhea. The treatment was determined to be beneficial by both patients and physicians and resulted in a better quality of life. Level of Evidence 1 Laryngoscope , 133:3247–3255, 2023