Sixteen trials (5,348 participants) were included. Only one trial met all five quality criteria, sequence generation and allocation concealment were unclear in the remaining studies. All studies were reported to be double blind.
Occular symptoms: Compared to placebo, intranasal fluticasone furoate nasal spray significantly improved rTOSS for seasonal rhinitis patients (WMD -0.54, 95% CI -0.70 to -0.37; six trials) and for perennial rhinitis patients (WMD -0.33, 95% CI -0.61 to -0.05; three trials). Significant improvements were also found for iTOSS for seasonal rhinitis patients (WMD -0.59, 95% CI -0.76 to -0.43; six trials) and for perennial rhinitis patients (WMD -0.38, 95% CI -0.69 to -0.07; two trials). There was no evidence of statistical heterogeneity (Ι²=0% for all comparisons). Significant improvements were reported for eye itching, burning, tearing, watering and redness for both perennial and seasonal rhinitis groups compared to placebo.
Nasal symptoms: Compared to placebo, intranasal fluticasone furoate nasal spray also significantly improved rTNSS for seasonal rhinitis patients (WMD -1.14, 95% CI -1.57 to -0.72; six trials, (Ι²=80%) and for perennial rhinitis patients (WMD -0.83, 95% CI -1.08 to -0.59; seven trials, Ι²=32%). Significant improvements were also found for iTNSS for seasonal rhinitis patients (WMD -1.32, 95% CI -1.64 to -1.01; six trials; Ι²=62%) and for perennial rhinitis patients (WMD -0.90, 95% CI -1.33 to -0.48; four trials; Ι²=52%). There were also significant improvements reported for rhinorrhoea, nasal congestion, nasal itching and sneezing for both seasonal and perennial rhinitis patients compared to placebo.
There were no significant differences between intranasal fluticasone furoate and placebo for early withdrawals, adverse effects and serious adverse effects except for incidence of epistaxis for perennial allergic rhinitis patients (number-needed-to-harm was 15, 95% CI 11 to 21). Other results of secondary outcomes were also reported.
There was no evidence of significant publication bias. Results were similar regardless of statistical model, or type of rhinitis.