Efficacy of Montelukast-Antihistamine Combination Therapy Compared with Antihistamine Monotherapy in Allergic Rhinitis: A Systematic Review and Meta-Analysis.

IF 3.4 3区医学 Q1 OTORHINOLARYNGOLOGY

Clinical and Experimental Otorhinolaryngology Pub Date : 2025-09-17 DOI:10.21053/ceo.2025-00201

Ji-Sun Kim, Gulnaz Stybayeva, Se Hwan Hwang

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Abstract

Objective: Allergic rhinitis (AR) impairs quality of life, and combination therapy is often required for comprehensive symptom control. This study aimed to evaluate the efficacy of montelukast-antihistamine combination therapy compared with antihistamine monotherapy in improving AR symptoms and quality of life.

Methods: PubMed, Embase, MEDLINE, Scopus, the Cochrane Library, and Google Scholar were searched up to April 2025. Eligible studies compared combination therapy with montelukast plus an antihistamine against antihistamine monotherapy and reported nasal symptoms or rhinoconjunctivitis quality of life questionnaire (RQLQ) scores. Standardized mean differences (SMDs) were calculated, and subgroup analyses were conducted according to antihistamine type.

Results: Fifteen studies including 2,882 subjects were analyzed. Combination therapy significantly improved daytime nasal symptoms (SMD [95% CI] = 0.44 [0.21-0.67]), nighttime nasal symptoms (SMD [95% CI] = 0.12 [0.01-0.23]), and RQLQ scores (SMD [95% CI] = 0.14 [0.00-0.27]) compared with monotherapy. Sneezing, nasal obstruction, and rhinorrhea improved significantly, while nasal itching and ocular symptoms did not. Combinations with desloratadine and levocetirizine showed greater benefits than those with loratadine or fexofenadine.

Conclusion: Montelukast-antihistamine combination therapy improves overall symptoms and quality of life compared with antihistamine monotherapy. The magnitude of benefit appears to vary depending on the specific antihistamine used, highlighting the potential value of individualized treatment strategies in the management of AR.

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孟鲁司特-抗组胺联合治疗与抗组胺单药治疗变应性鼻炎的疗效比较：一项系统综述和荟萃分析。

目的：变应性鼻炎（AR）严重影响患者的生活质量，需要综合治疗才能全面控制症状。本研究旨在评价孟鲁司特-抗组胺联合治疗与抗组胺单药治疗在改善AR症状和生活质量方面的疗效。方法：检索截至2025年4月的PubMed、Embase、MEDLINE、Scopus、Cochrane Library和谷歌Scholar。符合条件的研究比较了孟鲁司特联合抗组胺药与抗组胺药单一疗法的联合治疗，并报告了鼻症状或鼻结膜炎生活质量问卷（RQLQ）评分。计算标准化平均差异（SMDs），并根据抗组胺药类型进行亚组分析。结果：共纳入15项研究2882名受试者。与单药治疗相比，联合治疗显著改善了日间鼻部症状（SMD [95% CI] = 0.44[0.21-0.67]）、夜间鼻部症状（SMD [95% CI] = 0.12[0.01-0.23]）和RQLQ评分（SMD [95% CI] = 0.14[0.00-0.27]）。打喷嚏、鼻塞和鼻漏明显改善，而鼻痒和眼部症状没有改善。地氯雷他定和左西替利嗪联合使用比氯雷他定或非索非那定更有效。结论：与单药治疗相比，孟鲁司特-抗组胺联合治疗可改善患者的整体症状和生活质量。益处的大小似乎取决于所使用的特定抗组胺药，这突出了个体化治疗策略在AR管理中的潜在价值。

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 and Experimental Otorhinolaryngology 医学-耳鼻喉科学

CiteScore

4.90

自引率

6.70%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical and Experimental Otorhinolaryngology (Clin Exp Otorhinolaryngol, CEO) is an international peer-reviewed journal on recent developments in diagnosis and treatment of otorhinolaryngology-head and neck surgery and dedicated to the advancement of patient care in ear, nose, throat, head, and neck disorders. This journal publishes original articles relating to both clinical and basic researches, reviews, and clinical trials, encompassing the whole topics of otorhinolaryngology-head and neck surgery. CEO was first issued in 2008 and this journal is published in English four times (the last day of February, May, August, and November) per year by the Korean Society of Otorhinolaryngology-Head and Neck Surgery. The Journal aims at publishing evidence-based, scientifically written articles from different disciplines of otorhinolaryngology field. The readership contains clinical/basic research into current practice in otorhinolaryngology, audiology, speech pathology, head and neck oncology, plastic and reconstructive surgery. The readers are otolaryngologists, head and neck surgeons and oncologists, audiologists, and speech pathologists.