Objective: To systematically evaluate the efficacy and safety of leukotriene receptor antagonist (LTRA) combined intranasal corticosteroids in the treatment of allergic rhinitis (AR).
Method: The randomized controlled trials (RCT) about the combined therapy of LTRA and nasal corticosteroids from January 1985 to May 2014 were searched in OVID, PubMed, EMBASE, CNKI, WanFang Data, and Cochrane Library. Two reviewers independently screened the literatures, extracted the data, and evaluated the methodological quality. Then meta-ana- lyses were conducted by using RevMan 5.1 software.
Result: A total of 5 RCTs were included upon literature search. The results of meta-analyses showed that the efficacy of nasal corticosteroids plus LTRA was superior to nasal corticosteroids alone in total nasal symptom scores and individual nasal symptom scores (rhinorrhea, sneezing) [WMD = -4.49, 95% CI (-4.95(-)-4.03)-, P < 0.01; WMD = -0.43, 95% CI (-0.78(-)-0.07), P < 0.05; WMD = -0.10, 95% CI (-0.6(-)-0. 04), P < 0.01], with significant differences. However, compa- ring the subgroup treated with nasal corticosteroids combined LTRA against the subgroup treated with nasal corti- costeroids alone, we found no significant differences for RQLQ score and for individual nasal symptom scores (nasal blockage, nasal itching) [WMD = -15.19, 95% CI (-55.37(-)-25. 00), P > 0.05; WMD = 0.01, 95% CI(-) 0.06-0.08), P > 0. 05; WMD = -0.15,95% CI (-0.43(-)-0.13), P > 0.05].
Conclusion: Based on limited evidence, we preliminary concluded the combined therapy of nasal corticosteroids and LTRA was more effective than nasal corticosteroids alone in the management of AR. Further large-scale, well-designed RCTs were still required to validate the add-on efficacy of LTRA for AR patients.
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