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Wise et al.

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Author Manuscript Author Manuscript Author Manuscript Author Manuscript TABLE IX.B.10.c. Evidence for the use of combination leukotriene receptor antagonist and oral antihistamine in the treatment of allergic rhinitis Study Year LOE Study design Study groups Clinical endpoint Conclusion Wilson et al. 1300 2004 1a SR of RCTs, with homogeneity 1 LTRA + oral antihistamine; 2 LTRA; 3 Oral antihistamine; 4 INCS Symptoms, QOL Combination therapy improved symptoms vs either treatment alone. No differences in QOL measures. No difference in symptoms for combination therapy compared to INCS. Ciebiada et al. 1475 2013 1b RCT 1 Montelukast; 2 Oral antihistamine; 3 Montelukast + oral antihistamine; 4 Placebo Symptoms, ICAM-1 levels, eosinophilia Active treatments were superior to placebo at reducing symptoms, ICAM-1 levels and eosinophilia. Active treatments were not statistically different from each other. Yamamoto et al. 1476 2012 1b RCT 1 Montelukast + loratadine; 2 Montelukast + placebo Symptoms Combination therapy improved symptom scores, specifically sneezing and rhinorrhea. Cingi et al. 1477 2010 1b RCT 1 Fexofenadine + montelukast; 2 Fexofenadine + placebo; 3 Fexofenadine Symptoms, rhinomanometry Combination therapy improved symptoms and decreased nasal resistance compared to fexofenadine alone or with placebo. Li et al. 1478 2009 1b RCT 1 Fexofenadine + montelukast; 2 Fexofenadine Symptoms, acoustic rhinometry, cytokine levels Combination therapy improved symptoms, increased nasal volume by rhinometry. No difference in cytokine levels. Lu et al. 1479 2009 1b RCT 1 Montelukast + loratadine; 2 Beclomethasone INCS; 3 Montelukast; 4 Loratadine ; 5 Placebo Symptoms, QOL Combination therapy improved symptoms more than placebo or montelukast alone. There was no difference compared to loratadine alone. Combination therapy was inferior to beclomethasone INCS. Watanasomsiri et al. 1480 2008 1b RCT 1 Montelukast + loratadine; 2 Loratadine + placebo Symptoms, turbinate hypertrophy No difference in symptoms with combination therapy vs antihistamine alone. Turbinate swelling significantly reduced with combination therapy. DiLorenzo et al. 1472 2004 1b RCT 1 Montelukast + cetirizine; 2 Fluticasone INCS; Symptoms, peripheral eosinophilia, nasal eosinophil counts

Montelukast + cetirizine improved symptoms and decreased nasal eosinophil counts compared to placebo.

Int Forum Allergy Rhinol . Author manuscript; available in PMC 2020 June 10.