Montelukast in allergic rhinitis: a systematic review and meta‐analysis

Abstract

Allergic rhinitis is common. This systematic review outlines the evidence regarding montelukast in allergic rhinitis and provides a meta-analysis of its efficacy. The evidence suggests that montelukast does reduce nasal symptom score by 3.4% (95% CI: 2.5% to 4.2%) when compared with placebo. Montelukast is not as effective as topical nasal steroids or antihistamines and should therefore be regarded as second line therapy. When used, montelukast should be used in combination with an antihistamine.

International Union of Basic and Clinical Pharmacology. LXXXIV: Leukotriene Receptor Nomenclature, Distribution, and Pathophysiological Functions

“…Montelukast, which significantly reduced daytime nasal, eye and throat symptoms, nighttime symptoms, and symptoms affecting quality of life (QL) in adult patients with seasonal AR (Grainger and Drake-Lee, 2006;Nayak and Langdon, 2007;Bousquet et al, 2009), has also been demonstrated to be safe in children (Bisgaard et al, 2009). Similar results have also been obtained with zafirlukast (Piatti et al, 2003) and pranlukast (Ueda et al, 2003;Okubo and Baba, 2008).…”

Special considerations—asthma in children

“…86 Pediatric and adult-based literature does indicate that montelukast may have a significant benefit in improving nasal symptoms and lung function in those with comorbid allergic rhinitis and asthma. 87,88 Biologic therapies are increasingly being recognized as a potential treatment for moderate to severe persistent asthmatics who do not respond to conventional asthma therapies. Omalizumab is a monoclonal antibody that selectively binds to IgE and is indicated in patients as young as 6 years of age in Europe and >12 years of age in the…”

Seasonal Allergic Rhinitis

“…They are effective in controlling sneezing, nasal pruritus, rhinorrhea, and nasal congestion associated with allergic rhinitis [6,[62][63][64][65][66]. Leukotriene-receptor antagonists are less effective than intranasal corticosteroids but equivalent to oral antihistamines in the treatment of seasonal allergic rhinitis [67,68].…”