Potential clinical benefits of probiotics in pediatric allergic rhinitis: a systematic review and network meta-analysis
Abstract
Objective: This study aimed to evaluate potential clinical benefits and superior strains of probiotics for pediatric allergic rhinitis (AR) using meta-analysis and network meta-analysis.
Methods: A systematic search was conducted in databases including PubMed, Web of Science, Cochrane Library, and China National Knowledge Infrastructure up to July 31, 2025, to identify randomized controlled trials (RCTs). Inclusion criteria were pediatric patients with AR, probiotic interventions, control groups receiving placebo or standard treatment, and reported outcomes such as Total Nasal Symptom Score (TNSS), Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ), Total Symptom Score (TSS), serum total IgE levels, or clinical efficacy. Study quality was assessed using the JADAD scale, with meta-analysis and network meta-analysis (NMA) performed via RevMan and R software, calculating standardized mean differences (SMD), relative risks (RR), and surface under the cumulative ranking curve (SUCRA) values.
Results: Eighteen RCTs were included, involving 1,789 patients (963 in the probiotic group and 826 in the control group). Meta-analysis showed that probiotics significantly reduced TNSS (SMD = -0.85, 95%CI [-1.25, -0.44], P P P P = 0.12), or serum total IgE levels (SMD = -0.34, 95%CI [-0.84, 0.16], P = 0.18). Subgroup and NMA analyses indicated that mixed strains performed superiorly across multiple outcomes.
Conclusions: Probiotic supplementation, especially multi-strain…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,789 participants or records.
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