Antihistamines + LTRAs more effective than antihistamines alone in allergic rhinitis

The researchers conducted a meta-analysis after search on PubMed, EMBASE, and Cochrane Central Register of Controlled Trials and identified 8 randomised controlled trials (n=1886) that compared the efficacy of LTRAs plus H1 vs H1 alone in patients with AR. They evaluated daytime nasal symptoms, nighttime nasal symptoms, composite nasal symptoms, and eye symptoms.

The pooled results of all trials showed a significant reduction in total daytime (weighted mean difference [WMD], –0.11; 95% CI, –0.19 to –0.03) and composite (WMD, –0.12; 95% CI, –0.23 to –0.01) nasal symptoms in H1 + LTRAs group vs H1 alone group.The pooled results of 3 trials showed that H1 + LTRAs group had significant improvement in composite nasal congestion (WMD, –0.06; 95% CI, –0.12 to –0.01), rhinorrhea (WMD, –0.34; 95% CI, –0.53 to –0.14), sneezing (WMD, –0.30; 95% CI, –0.42 to –0.18) except for nasal itching (WMD, –0.11; 95% CI, –0.26 to 0.04) vs H1 alone group. No significant difference was seen in nighttime nasal symptoms and eye symptoms between the 2 groups.

It was concluded that the current evidence suggests that LTRAs + H1 can increase the therapeutic efficacy against daytime and composite nasal symptoms, including rhinorrhea, sneezing, and itching; however, it does not affect nighttime nasal symptoms and eye symptoms. The patients with perennial AR may benefit more from the combination therapy.