Efficacy of montelukast for adenoid hypertrophy in paediatrics: A systematic review and meta-analysis

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology Pub Date : 2024-05-03 DOI:10.1111/coa.14169

Farhan Alanazi, Moteb Alruwaili, Sultan Alanazy, Mazyad Alenezi

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引用次数: 0

Abstract

Introduction

Leukotrienes play a significant role in the pathogenesis of adenoid hypertrophy (A.H.). Therefore, we aimed to analyse the role of montelukast, a leukotriene receptor antagonist, alone or in combination with mometasone, a potent local intranasal steroid, for the treatment of A.H.

Methods

Participants were children with A.H. were treated with montelukast alone or montelukast and mometasone furoate. The main outcome measures were effect of montelukast on clinical symptoms of A.H. A literature review was conducted using online search engines, Cochrane Library, PubMed, Web of Science and Scopus, for randomized clinical trials assessing children with A.H. treated with montelukast alone or montelukast and mometasone furoate. Seven randomized clinical trials (RCTs) were included with 742 children.

Results

Our study reveals that montelukast alone or in combination with intranasal mometasone furoate significantly improves clinical symptoms of adenoid hypertrophy such as snoring, sleeping disturbance, mouth breathing and A/N ratio. Montelukast was superior to placebo in decreasing snoring (SMD = −1.00, 95% CI [−1.52, −0.49]), sleep discomfort (SMD = −1.26, 95% CI [−1.60, −0.93]), A/N ratio (MD = −0.11, 95% CI [−0.14, −0.09]) and mouth breathing (SMD = −1.36, 95% CI [−1.70, −1.02]). No difference was detected between montelukast and mometasone versus mometasone alone in snoring (SMD = −0.21, 95%CI [−0.69, 0.27]); however, the combination group was superior to the mometasone alone in mouth breathing (SMD = −0.46, 95% CI [−0.73, −0.19]).

Conclusions

The limitation of studies included a small sample size, with an overall low to medium quality. Thus, further larger, higher-quality RCTs are recommended to provide more substantial evidence.

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孟鲁司特治疗儿科腺样体肥大的疗效：系统回顾和荟萃分析

导言白三烯在腺样体肥大（A.H.）的发病机制中起着重要作用。因此，我们旨在分析白三烯受体拮抗剂孟鲁司特单独或与强效局部鼻内类固醇莫美他松联合治疗腺样体肥大的作用。我们使用在线搜索引擎 Cochrane Library、PubMed、Web of Science 和 Scopus 进行了文献综述，以了解评估单独使用孟鲁司特或孟鲁司特联合糠酸莫米松治疗甲流患儿的随机临床试验。结果我们的研究显示，单独使用孟鲁司特或与糠酸莫米松联合使用可明显改善腺样体肥大的临床症状，如打鼾、睡眠障碍、口呼吸和 A/N 比值。孟鲁司特在减少打鼾（SMD =-1.00，95% CI [-1.52，-0.49]）、睡眠不适（SMD =-1.26，95% CI [-1.60，-0.93]）、A/N 比率（MD =-0.11，95% CI [-0.14，-0.09]）和口呼吸（SMD =-1.36，95% CI [-1.70，-1.02]）方面优于安慰剂。在打鼾（SMD = -0.21，95%CI [-0.69，0.27]）方面，孟鲁司特和莫米他松与单用莫米他松相比未发现差异；但在口呼吸（SMD = -0.46，95%CI [-0.73，-0.19]）方面，联合用药组优于单用莫米他松组。因此，建议进一步开展规模更大、质量更高的 RCT 研究，以提供更多实质性证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.