BACKGROUND Intranasal corticosteroid (INCS) has a beneficial effect on ocular symptoms in allergic rhinitis (AR). To our knowledge, the cost-effectiveness of available INCS for AR with ocular symptoms is yet to be demonstrated. OBJECTIVE To evaluate the cost-effectiveness of INCSs including Budesonide (BANS), Mometasone furoate (MFNS), Triamcinolone (TANS), and Fluticasone furoate (FFNS) on ocular symptoms associated with AR in the Thai context. METHODS The percentage of effectiveness in improving total ocular symptoms score (TOSS) was derived from the result of a meta-analysis that estimated the SMD of each INCS treatment compared to placebo as clinical input parameters. A cost-effectiveness analysis based on a decision-tree model to assess one-year costs and outcomes from a Thai societal perspective. The outcomes were to compare incremental cost-effectiveness ratio (ICER). Probabilistic sensitivity analyses (PSA) were also conducted to capture parameter uncertainties. RESULTS 13 eligible RCTs with a total of 3,722 patients with SAR were included in the analysis. The percentage of effectiveness of FFNS, MFNS, TANS, and BANS was 59.89%, 45.60%, 24.89%, and 16.00%, respectively. The ICER of FFNS, MFNS, and TANS is THB-6,539.92, 4,593.83, and 1,401.24 compared to BANS. CECA result showed the probability of using FFNS is considered cost-effective in 87.50% of cases from zero value followed by MFNS (0.80%), TANS (5.40%), and BANS (6.30%). With a threshold greater than THB20,000, FFNS is considered a cost-effective strategy. CONCLUSIONS FFNS is a cost-effective option compared to alternative INCSs in Thailand for treating AR with ocular symptoms.

中文翻译：

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鼻内皮质类固醇治疗伴眼部症状的过敏性鼻炎的荟萃分析和成本效益分析。

背景鼻内皮质类固醇（INCS）对过敏性鼻炎（AR）的眼部症状有有益作用。据我们所知，现有 INCS 治疗具有眼部症状的 AR 的成本效益尚未得到证实。目的 评估泰国环境中包括布地奈德 (BANS)、糠酸莫米松 (MFNS)、曲安西龙 (TANS) 和糠酸氟替卡松 (FFNS) 在内的 INCS 对与 AR 相关眼部症状的成本效益。方法 改善总眼部症状评分 (TOSS) 的有效性百分比源自一项荟萃分析的结果，该荟萃分析估计了每种 INCS 治疗与安慰剂相比的 SMD 作为临床输入参数。基于决策树模型的成本效益分析，从泰国社会的角度评估一年的成本和结果。结果是比较增量成本效益比（ICER）。还进行了概率敏感性分析（PSA）以捕获参数不确定性。结果 分析中纳入了 13 项符合条件的随机对照试验，共计 3,722 名 SAR 患者。FFNS、MFNS、TANS 和 BANS 的有效率分别为 59.89%、45.60%、24.89% 和 16.00%。与 BANS 相比，FFNS、MFNS 和 TANS 的 ICER 分别为 THB-6,539.92、4,593.83 和 1,401.24。CECA 结果显示，使用 FFNS 的概率在 87.50% 的情况下被认为具有成本效益（从零值开始），其次是 MFNS（0.80%）、TANS（5.40%）和 BANS（6.30%）。FFNS 的门槛高于 20,000 泰铢，被认为是一种具有成本效益的策略。结论 在泰国，与其他 INCS 相比，FFNS 是一种具有成本效益的治疗 AR 眼部症状的选择。