Prevalence and bidirectional association between rhinitis and urticaria: A systematic review and meta-analysis

Background: Rhinitis, allergic rhinitis in particular, and urticaria are both common atopic problems globally. However, there is controversy regarding the correlation between rhinits and urticaria. Objectives: To examine the accurate association between rhinitis and urticaria. Methods: Three medical databases (PubMed, Embase, and Web of Science) were searched from database inception until January 11, 2022. The prevalence and association between rhinitis and urticaria were estimated by meta-analysis. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed, and quality assessment was performed using the Newcastle–Ottawa Scale. Pooled odds ratios (OR) with 95% confidence intervals (95% CI) and pooled prevalence were calculated using random-effects models. Results: Urticaria prevalence in patients with rhinitis was 17.6% (95% CI, 13.2%–21.9%). The pooled prevalence of rhinitis was 31.3% (95% CI, 24.2%–38.4%) in patients with urticaria, and rhinitis prevalence in patients with acute urticaria and chronic urticaria was 31.6% (95% CI, 7.4%–55.8%) and 28.7% (95% CI, 20.4%–36.9%), respectively. Rhinitis occurence was significantly associated with urticaria (OR, 2.67; 95% CI, 2.625–2.715). Limitations: Urticaria and rhinitis were diagnosed based on different criteria possibly resulting in a potential misclassification of these two diseases. Conclusion: Rhinitis and urticaria were significantly correlated. Physicians should be cognizant regarding this relationship and address nasal or skin symptoms in patients.