PDF(Pubmed)
Abstract：
Background: Loratadine and montelukast are clinical first-line drugs in the treatment of allergic rhinitis (AR). However, there is no clear evidence of the efficacy of loratadine combined with montelukast in the treatment of AR. This study aimed to evaluate the efficacy and safety of the loratadine-montelukast combination on AR. Methods: In this meta-analysis, searches were conducted on PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and China National Knowledge Infrastructure (CNKI). The search terms included loratadine, montelukast, allergic rhinitis, and clinical trials. Meta-analyses were conducted using Rev Man 5.3 and Stata 15 statistical software. Results: A total of 23 studies with 4,902 participants were enrolled. For the primary outcome, pooled results showed that loratadine-montelukast can significantly reduce total nasal symptom scores (TNSS), when compared with loratadine (SMD, -1.00; 95% CI, -1.35 to -0.65, p < 0.00001), montelukast (SMD, -0.46; 95% CI, -0.68 to -0.25, p < 0.0001), or placebo (SMD, -0.93; 95% CI, -1.37 to -0.49, p < 0.00001). For secondary outcomes, pooled results showed that compared with loratadine, loratadine-montelukast can significantly improve nasal congestion, nasal itching, nasal sneezing, nasal rhinorrhea, and rhinoconjunctivitis quality of life questionnaires (RQLQ). Compared with montelukast, loratadine-montelukast can significantly improve nasal itching, and nasal sneezing. Compared with placebo, loratadine-montelukast can significantly improve nasal congestion, and RQLQ. Conclusion: Loratadine-montelukast combination is superior to loratadine monotherapy, montelukast monotherapy, or placebo in improving AR symptoms. Therefore, loratadine-montelukast combination can be an option for patients with moderate-severe AR or poorly response to monotherapy. Systematic review registration number: clinicaltrials.gov, identifier CRD42023397519.
摘要：
背景：氯雷他定和孟鲁司特是治疗变应性鼻炎（AR）的临床一线药物。然而,目前尚无明确证据证明氯雷他定联合孟鲁司特治疗AR的疗效.本研究旨在评估氯雷他定-孟鲁司特联合治疗AR的疗效和安全性。方法：在本荟萃分析中，搜索是在PubMed上进行的，Embase,Cochrane中央受控试验登记册,WebofScience,和中国国家知识基础设施(CNKI)。搜索词包括氯雷他定,孟鲁司特,过敏性鼻炎,和临床试验。采用RevMan5.3和Stata15统计软件进行Meta分析。结果：共有23项研究纳入4,902名参与者。对于主要结果，汇总结果显示，氯雷他定-孟鲁司特可显著降低鼻部症状总评分（TNSS），与氯雷他定（SMD，-1.00；95%CI，-1.35至-0.65，p<0.00001），孟鲁司特（SMD，-0.46；95%CI，-0.68至-0.25，p<0.0001），或安慰剂(SMD，-0.93；95%CI，-1.37至-0.49，p<0.00001）。对于次要结果，汇总结果显示，与氯雷他定相比，氯雷他定-孟鲁司特可显着改善鼻塞，鼻痒,鼻腔打喷嚏,鼻漏,和鼻结膜炎生活质量问卷（RQLQ）。与孟鲁司特相比,氯雷他定-孟鲁司特可显着改善鼻痒，还有鼻部打喷嚏.与安慰剂相比，氯雷他定-孟鲁司特可显着改善鼻塞，和RQLQ。结论:氯雷他定-孟鲁司特联合用药优于氯雷他定单药治疗,孟鲁司特单药治疗,或安慰剂改善AR症状。因此,氯雷他定-孟鲁司特联合治疗可作为中度-重度AR或单药治疗反应差的患者的一种选择。系统审查登记号：clinicaltrials.gov，标识符CRD42023397519。
