Intranasal antihistamines and corticosteroids for AR: Insights from MASK-air study

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Created On: 16/05/2026

Allergic rhinitis (AR) significantly affects daily functioning, symptom burden, and overall health-related quality of life.

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Key take away

Fixed intranasal antihistamine–corticosteroid combinations demonstrate superior quality-of-life and health utility outcomes in allergic rhinitis when compared with oral antihistamines and intranasal antihistamine monotherapy.

Background

Allergic rhinitis (AR) significantly affects daily functioning, symptom burden, and overall health-related quality of life. This study investigated the real-world impact of different AR treatment options on patient-reported quality of life using data from the MASK-air digital health platform.

Method

A large observational analysis was carried out using patient-reported data collected through the MASK-air mobile application. The study compared both medication classes and specific AR drugs on the basis of EuroQol 5-Dimension 5-Level questionnaire (EQ-5D-5L) utility values and EuroQol 5-Dimension Visual Analogue Scale (EQ-5D VAS) scores. To minimize confounding bias, inverse probability treatment weighting with propensity score adjustment was applied, considering demographic variables, asthma status, and baseline symptom severity.

Result

A total of 69,973 records containing EQ-5D VAS data and 842 observations with utility data were included in the analysis. Combination therapy using intranasal antihistamines plus corticosteroids illustrated superior improvements in health-related quality of life compared with oral antihistamines, showing higher EQ-5D VAS scores (mean difference = 1.900) and improved utility outcomes (mean difference = 0.022).

In contrast, intranasal antihistamine monotherapy was linked to lower quality-of-life scores than other nasal treatment strategies. Among individual medications, mometasone illustrated lower VAS performance than budesonide and fluticasone furoate, while fexofenadine and levocetirizine were linked with comparatively lower VAS scores among oral antihistamines.

Conclusion

For AR, fixed-dose combinations of intranasal antihistamines and corticosteroids may provide greater quality-of-life benefits when compared with oral antihistamines or intranasal antihistamine therapy alone.