Comparison of Allergic Rhinitis Treatments on Patient Satisfaction: A MASK-air and EAACI Methodological Committee Report

Introduction: Satisfaction with treatments may affect medication adherence and use patterns, including the use of co-medication. We aimed to compare different medications for allergic rhinitis (AR) on (i) patients' satisfaction and (ii) co-medication use frequency. Methods: We assessed data from the mHealth app MASK-air. We evaluated days on which users with self-reported AR had used—alone or in co-medication—intranasal corticosteroids (INCS), intranasal antihistamines (INAH), fixed combinations of INAH+INCS, or oral antihistamines (OAH). We built multivariable regression models to compare these different AR medication classes (as well as individual medications) on their (i) treatment satisfaction levels (measured using a specific daily visual analogue scale [‘VAS satisfaction’]) and (ii) odds of being used in co-medication. Results: We assessed 28,177 days reported by 1691 MASK-air users. For all medication classes, co-medication usage was associated with lower treatment satisfaction. When used in monotherapy, OAH were associated with lower VAS satisfaction than INCS (−1.7 points; 95% CI = –2.7; –0.7) or INAH+INCS (−2.1 points; 95% CI = –3.5; –0.7). INCS displayed higher odds of being used in co-medication than OAH (OR = 1.3; 95% CI = 1.0; 1.6) or INAH+INCS (OR = 1.3; 95% CI = 0.8; 1.8). When comparing individual intranasal medications, fluticasone furoate and fluticasone propionate tended to be more frequently used in co-medication. Among individual OAH, desloratadine and rupatadine were associated with higher satisfaction, while fexofenadine was more frequently used in co-medication. Conclusion: Using patient-reported data, we evaluated different medication classes and treatments in terms of satisfaction and co-medication frequency. These results provide key insights into the acceptability of AR treatments and will contribute to future treatment guidelines.