TABLE IX.B.4.
Evidence for the use of leukotriene receptor antagonists as monotherapy in the treatment of allergic rhinitis (Level 1a and 1b studies only)
Study | Year | LOE | Study design | Study groups | Clinical endpoint | Conclusion |
---|---|---|---|---|---|---|
Devillier et al.1332 | 2014 | 1a | SR of RCTs, with homogeneity |
|
Symptoms | SLIT superior clinical effect to LTRA. LTRA with clinical effect compared to placebo. |
Goodman et al.1347 | 2008 | 1a | SR of RCTs, with homogeneity |
|
Symptoms, cost | Montelukast with higher incremental cost-effectiveness ratio than levocetirizine and desloratadine. |
Grainger & Drake-Lee1333 | 2006 | 1a | SR of RCTs, with homogeneity |
|
Symptoms, QOL | Montelukast improved symptoms and QOL compared to placebo, and was inferior to oral antihistamines and INCS. |
Rodrigo & Yanez1334 | 2006 | 1a | SR of RCTs, with homogeneity |
|
Symptoms, QOL | LTRA improved symptoms and QOL compared to placebo, was equally effective to oral antihistamine, and inferior to INCS. |
Wilson et al.1300 | 2004 | 1a | SR of RCTs, with homogeneity |
|
Symptoms, QOL | Montelukast improved QOL compared to placebo, and was inferior to antihistamines and INCS. |
Gonyeau & Partisan1335 | 2003 | 1a | SR of RCTs, with homogeneity |
|
Symptoms | Montelukast was more effective than placebo in reducing symptoms, but was inferior to INCS. |
Endo et al.1336 | 2012 | 1b | RCT |
|
Symptoms | Pranlukast prevented and reduced symptoms compared to placebo after artificial introduction of allergen. |
Wakabayashi et al.1337 | 2012 | 1b | RCT |
|
Symptoms | Pranlukast reduced symptoms compared to placebo in children with artificial allergen exposure. |
Day et al.1338 | 2008 | 1b | RCT |
|
Symptoms | Both montelukast and levocetirizine improved symptoms following artificial allergen exposures. Levocetirizine was more effective than montelukast. |
Jiang1348 | 2006 | 1b | RCT |
|
Symptoms, acoustic rhinometry, rhinomanometry | All treatment groups had a significant reduction of pretreatment symptoms. Zafirlukast was superior at reduction of nasal congestion. There were no differences in acoustic rhinometry and rhinomanometry between the 3 treatment groups. |
Mucha et al.1321 | 2006 | 1b | RCT |
|
Symptoms, QOL, nasal peak inspiratory flow | Montelukast and pseudoephedrine had equivalent improvement of symptoms (except nasal congestion for which pseudoephedrine was more effective), QOL, and nasal peak inspiratory flow. |
Patel et al.1339 | 2005 | 1b | RCT |
|
Symptoms, QOL | Montelukast was more effective than placebo in reducing symptoms and improving QOL in patients with perennial allergic rhinitis |
Chervinsky et al.1340 | 2004 | 1b | RCT |
|
Symptoms, pollen count | Montelukast was more effective than placebo in reducing symptoms. The effect size was related to the amount of pollen exposure. |
Philip et al.1341 | 2004 | 1b | RCT |
|
Symptoms, rhinitis QOL, asthma QOL | Montelukast improved symptoms, rhinitis QOL, and asthma QOL compared to placebo in patients with concurrent seasonal allergic rhinitis and asthma. |
Ratner et al.1345 | 2003 | 1b | RCT |
|
Symptoms, QOL | Fluticasone was more effective than montelukast in reducing symptoms and improving QOL. |
van Adelsburg et al.1342 | 2003 | 1b | RCT |
|
Symptoms, QOL | Montelukast was more effective than placebo in reducing symptoms and improving QOL. Montelukast not directly compared to loratadine. |
van Adelsburg et al.1343 | 2003 | 1b | RCT |
|
Symptoms, QOL | Montelukast was more effective than placebo in reducing symptoms and improving QOL. Montelukast not directly compared to loratadine. |
Philip et al.1344 | 2002 | 1b | RCT |
|
Symptoms, QOL, peripheral eosinophil count | Montelukast was more effective than placebo in reducing symptoms and peripheral eosinophil count, and improving QOL. Montelukast not directly compared to loratadine. |
Pullerits et al.1346 | 1999 | 1b | RCT |
|
Symptoms, tissue eosinophilia | Zafirlukast was not different from placebo in symptom or tissue eosinophilia reduction. Both were inferior to intranasal beclomethasone. |
INCS = intranasal corticosteroids; LOE = level of evidence; LTRA = leukotriene receptor antagonist; QOL = quality of life; RCT = randomized controlled trial; SLIT = sublingual immunotherapy; SR = systematic review.