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Wise et al.

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Study Year LOE Study design Study groups Clinical endpoint Conclusion 3 Fluticasone INCS + cetirizine; Generally inferior to fluticasone INCS alone or in combination. Moinuddin et al. 1467 2004 1b RCT 1 Montelukast + loratadine; 4 Fluticasone INCS + montelukast; 5 Placebo

2 Fexofenadine + pseudoephedrine symptoms, QOL, and nPIF. Montelukast + loratadine reduced sleep domain symptoms. Saengpanich et al. 1481 2003 1b RCT 1 Montelukast + loratadine; 2 Fluticasone INCS Symptoms, nasal eosinophil count, nasal ECP level No difference in total symptom score, but nasal

symptoms reduced in the fluticasone group. Decreased eosinophil cell count and ECP level in the fluticasone group. Nayak et al. 1482 2002 1b RCT 1 Montelukast + loratadine; 2 Montelukast; 3 Loratadine; 4 Placebo Symptoms, QOL, peripheral eosinophilia

Combination therapy decreased symptoms and improved QOL compared to placebo. Effect did not reach statistical significance compared to monotherapy. Combination therapy decreased peripheral eosinophilia compared to placebo and loratadine only. Meltzer et al. 1483 2000 1b RCT 1 Montelukast + loratadine; 2 Montelukast; 3 Loratadine; 4 Placebo

Symptoms, QOL Combination therapy improved symptoms and QOL compared to placebo. Combination therapy not directly compared to monotherapy.

Symptoms, QOL, nPIF No significant difference between treatment groups for

ECP = eosinophil cationic protein; ICAM = intercellular adhesion molecule; INCS = intranasal corticosteroid; LOE = level of evidence; LTRA = leukotriene receptor antagonist; nPIF = nasal peak inspiratory flow; QOL = quality of life; RCT = randomized controlled trial; SR = systematic review.

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