Leukotriene receptor antagonist addition to intranasal steroid: systematic review and meta-analysis

Background: Intranasal corticosteroids (INCS) and leukotriene receptor antagonist (LTRA) have different mechanisms of action. The combination of INCS and LTRA (INCS+LTRA) are utilized to control the allergic rhinitis (AR) symptoms. The effects of this combination have not been made evident yet. Methodology: Randomized controlled trials studying the effects of INCS+LTRA vs INCS in monotherapy on rhinoconjunctivitis symptoms in patients with AR were included. Data were pooled for meta-analysis. The outcomes were nasal symptoms, ocular symptoms, disease-specific quality of life (QOL), and adverse events. Results: Six studies (358 participants) met the inclusion criteria. There were no differences between INCS+LTRA and INCS monotherapy on composite nasal symptom score, total daytime symptom score, total night time symptom score, disease-specific QOL and adverse events. The results favoured the effects of INCS-LTRA on ocular symptoms. Conclusions: The effects of the INCS+LTRA combination are not different from INCS in monotherapy in the improvement of both nasal symptoms and patient's QOL. The combination may, however, be better on improving ocular symptoms.

Automated summary

The combination of INCS and LTRA showed no difference compared to INCS in monotherapy in improving nasal symptoms and patient's quality of life, but may be more effective in improving ocular symptoms.