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. Author manuscript; available in PMC: 2020 Jun 10.
Published in final edited form as: Int Forum Allergy Rhinol. 2018 Feb;8(2):108–352. doi: 10.1002/alr.22073

TABLE X.A.4-3.

Evidence for leukotriene receptor antagonists for the treatment of asthma in the context of coexistent allergic rhinitis

Study Year LOE Study design Study groups Clinical endpoint Conclusion
Katial et al.1841 2010 1b RCT SAR and asthma (n = 1385):

  1. FP-salmeterol inhaled 100/50 μg twice daily;

  2. FP-salmeterol inhaled 100/50 μg twice daily + FP INCS 200 μg daily;

  3. FP-salmeterol inhaled 100/50 μg twice daily + montelukast 10 mg daily;

  4. Montelukast 10 mg daily

 PEF, rescue albuterol use, asthma and rhinitis symptoms No additional improvements in asthma with montelukast plus FP-salmeterol. FP-salmeterol associated with improvement in all outcome measures vs montelukast.
Price et al.1842 2006 1b DBRCT; analysis of COMPACT trial data Asthma symptoms despite inhaled corticosteroid. Subgroup with coexistent AR. (n = 889).

  1. Montelukast + budesonide;

  2. Double dose budesonide

 Improvement in morning PEF compared to baseline Least-squares mean difference of morning PEF greater increase from baseline in montelukast + budesonide vs double dose budesonide.a
Nathan et al.1838 2005 1b RCT, plus open-label SAR and persistent asthma (n = 863):

  1. FP INCS 200 μg;

  2. Montelukast 10 mg;

  3. Placebo.

All received inhaled FP-salmeterol.		 Daily PEF, daily asthma and AR symptoms, rescue albuterol use FP INCS improved nasal symptoms. No asthma outcome improvement with FP INCS addition to inhaled FP-salmeterol.
Philip et al.1341 2004 1b DBRCT SAR and asthma (n = 831):

  1. Montelukast 10 mg daily;

  2. Placebo

 Rhinitis symptoms, RQLQ, global evaluations of asthma, β-agonist medication use Global evaluation of asthma by patients and physicians improved with montelukast. Reduction in β-agonist medication use montelukast.
Baena-Cagnani et al.1828 2003 1b DBRCT SAR and asthma (n = 924):

  1. Desloratadine 5 mg;

  2. Montelukast 10 mg;

  3. Placebo

 TASS, FEV1, β-agonist medication use Montelukast vs placebo: reduction in mean TASS, improvement in FEV1, reduction in average β-agonist medication use. Desloratadine vs montelukast: no differences.
a

Least squared mean difference in Price et al. study calculated as [(montelukast + budesonide) – double dose budesonide].

AR = allergic rhinitis; COMPACT = Clinical Outcomes with Montelukast as a Partner Agent to Corticosteroid Therapy; DBRCT = double-blind randomized controlled trial; FEV1 = forced expiratory volume in 1 second; FP = fluticasone propionate; INCS = intranasal corticosteroid; LOE = level of evidence; PEF = peak expiratory flow; RCT = randomized controlled trial; RQLQ = Rhinoconjunctivitis Quality of Life Questionnaire; SAR = seasonal allergic rhinitis; TASS = Total Asthma Symptom Severity Score.