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Orlandi et al.

TABLE IX-36 Evidence for CRSsNP management with anti-leukotriene therapy Study Year LOE Study Design Study Groups Clinical Endpoint Conclusions Chen 1180 2018 2 Randomized open-label study of 100 pts assigned to 2 weeks of 256 ug budesonide nasal spray, 10 mg montelukast, or 128 ug budesonide + montelukast Seasonal Allergic Rhinitis Symptom scores nasal cavity volume FeNO nasal mediator levels All 3 treatment arms improved symptoms from baseline but the ½ dose budesonide + montelukast combo produced greater improvements in nasal congestion than either drug alone. FeNO was also more decreased by the combination than by either drug alone. Goh 1178 2014 2 RDBPCT of 128 patients: INCS + placebovs INCS + montelukast Allergic Rhinitis Symptom scores QoLscores Medication usage Improvements in symptom scores and QoL scores after 1 and 2 months were significantly greater in the montelukast + INCS than the placebo + INCS arm, with less

Montelukast, levocetirizine and their combination was equally effective in controlling symptoms, with equivalent improvement in symptom scores.

rescue antihistamine use in the montelukast arm.

The 2 arms with INCS showed significant improvements in olfaction, but the arm with

montelukast alone did not and the addition of montelukast did not further improve.

Addition of montelukast showed improvements in subjective symptom scores but no changes in PNIF or PFTs.

symptoms at night and during the day

Seasonal Rhinitis Olfactory function with Sniffin’ Sticks

Allergic Rhinitis VAS for nasal and eye

Symptom improvement PNIF PFTs

CRS, allergic and non-allergic.

Andhale 1181 2016 3 Prospective open label trial of 75 patients for montelukast vs

levocetirizine for 2 weeks

Dalgic 1179 2017 3 Randomized open-label of 30 patients to 1 month

of either montelukast or INCS or both

Wilson 1177 2001 4 Case series of 32 pts with uncontrolled CRS,

despite INCS, for whom

montelukast was added