This study was carried out to examine the usefulness of different oral H1 antihistamine therapies in people with allergic rhinitis.

In this network meta-analysis, the search was executed in ClinicalTrials.gov, PubMed, Embase, OVID, and the Cochrane Library for relevant studies. With the aid of Stata 16.0, the network meta-analysis was performed. Symptom score reductions of patients were the outcome measures of the analysis. Relative risks with 95% confidence intervals were utilized to assess the clinical effects of treatments. Surface Under the Cumulative Ranking Curves (SUCRAs) were also calculated for ranking the treatments’ efficacy.

In total, eighteen eligible randomized controlled studies and 9419 participants were encompassed.

In terms of total symptom score decrease and each individual symptom score decrease, all the antihistamine therapies were found to outperform placebo. In terms of decrease in ocular symptom score (SUCRA: 97.2%, 88.8%), rhinorrhea score (SUCRA: 96.6%, 74.6%), nasal congestion score (SUCRA: 96.4%, 76.4%), and total symptom score (SUCRA: 99.7%, 76.3%), 20 mg Rupatadine and 10 mg Rupatadine were ranked relatively high as per the SUCRA results.

In terms of decrease in nasal itching score (SUCRA: 84.8%, 83.4%) and sneezing score (SUCRA: 87.3%, 95.4%), 20 mg Rupatadine and 5 mg Levocetirizine were ranked comparatively high. In each symptom score decrease besides placebo, 10 mg of Loratadine was ranked the lowest.

Hence, Rupatadine is the most effective agent in mitigating the symptoms of allergic rhinitis-affected people among different oral H1 antihistamine treatments implicated, and 20 mg Rupatadine performs better than 10 mg Rupatadine. When compared to other antihistamine therapies, 10 mg of Loratadine has inferior efficacy for patients with nasal inflammatory illness.