Homeopathy Vs. Conventional Antihistamines: A Comparative Study in Seasonal Allergic Rhinitis

Abstract

Abstract

Sneezing, rhinorrhoea, nasal itching, nasal congestion and eye symptoms are common symptoms of seasonal allergic rhinitis, which is a common inflammatory airway disease. While the use of oral H1-antihistamines is a proven symptomatic treatment, homeopathy is a controversial complementary treatment that has a relatively small and less consistent evidence base. The present article offers a structured comparative synthesis, focusing on literature that was published since the last 4 years (2023), particularly on randomized controlled trials, network meta-analysis and current clinical guidelines. Central homeopathy evidence refers to a 2026 double-blind, placebo-controlled, multicentre study in S.A.R. Sixty-two participants were randomized to standardized Galphimia glauca treatment, individualized homeopathic treatment or placebo. There was no significant difference between groups at week 3 and 4 for the primary Rhinitis QOL Questionnaires outcome (p = .244). 86.4%, 66.7% and 81.3% of people responded at week four, with no significant between-group differences reported with regard to rescue medication, total nasal symptom score or total non-nasal symptom score. There were eight AE reported with no SAE. The main conventional evidence was the results of a network meta-analysis conducted in 2026, which included 74 randomized controlled trials (RCTs), including 53 seasonal allergic rhinitis (SAR) trials, and showed that several second-generation oral antihistamines had strong evidence for efficacy on nasal symptoms and that there were many small differences between the drugs, with only low or very low certainty. The 2024–2025 ARIA-EAACI guideline update suggests that oral H1-antihistamines are superior to no treatment, and second-generation agents are superior to first-generation agents, with intranasal corticosteroids being better than oral antihistamines for overall allergic-rhinitis management. A 2023 network meta-analysis also confirms clinically significant efficacy with oral H1-antihistamines. The research gap lies in the lack of adequate powered, head-to-head, prospectively registered comparisons, with a defined modern antihistamine, with the same population, seasonal exposure, symptom scales, quality of life scales, and rescue medication rules and safety endpoints. The article outlines a rigorous comparative trial framework and suggests that harmonisation of outcomes and adequate samples sizes and reporting are priorities.