Efficacy and safety of montelukast–levocetirizine combination therapy in combined allergic rhinitis and asthma syndrome: a systematic review and meta-analysis

This meta-analysis aims to evaluate the efficacy and safety of montelukast combined with levocetirizine in the treatment of allergic rhinitis with asthma, and to provide objective and effective evidence-based medical evidence for clinical use. PubMed, Web of Science, Cochrane Library, WANFANG DATA, CNKI, and Chinese BioMedical Literature Database were retrieved to identify records related to montelukast combined with levocetirizine in the treatment of allergic rhinitis with asthma. First, the eligibility criteria were employed to screen search results. Then, two investigators independently assessed titles, abstracts, and the full text of all retrieved references to identify potentially eligible studies. As of 2024-02-03, a total of six articles were included in this meta-analysis, covering 2,950 patients with allergic rhinitis with asthma. The meta-analysis results exhibited a pooled NSS of −1.28 (95%CI: −1.64 to −0.92), suggesting that the combination of montelukast and levocetirizine was effective in the treatment of nasal symptoms of allergic rhinitis complicated with asthma. The meta-analysis of controlled trials showed that the SMD of NSS in the group of montelukast combined with levocetirizine was −2.56 (95%CI: −2.77 to −2.35). The result indicated that compared with the control group, the combination of montelukast with levocetirizine significantly improved the symptoms of allergic rhinitis. In summary, this meta-analysis demonstrated the efficacy of montelukast combined with levocetirizine in the treatment of nasal symptoms in AR with asthma, indicating that the combination of montelukast with levocetirizine is more effective in improving symptoms of allergic rhinitis than monotherapy and has good safety.

本荟萃分析旨在评估孟鲁司特（montelukast）联合左西替利嗪（levocetirizine）治疗伴哮喘的变应性鼻炎（allergic rhinitis, AR）的疗效与安全性，为临床应用提供客观有效的循证医学证据。本研究检索PubMed、Web of Science、Cochrane图书馆、万方数据（WANFANG DATA）、中国知网（CNKI）及中国生物医学文献数据库（Chinese BioMedical Literature Database），以筛选孟鲁司特联合左西替利嗪治疗伴哮喘变应性鼻炎的相关文献记录。首先采用纳入排除标准对检索结果进行初筛；随后由2名研究者独立对所有检索到的文献标题、摘要及全文进行评估，甄别潜在符合纳入标准的研究。截至2024年2月3日，本荟萃分析共纳入6篇文献，涵盖2950例伴哮喘变应性鼻炎患者。荟萃分析结果显示，合并后的鼻症状评分（Nasal Symptom Score, NSS）为-1.28（95%置信区间：-1.64至-0.92），表明孟鲁司特联合左西替利嗪可有效改善伴哮喘变应性鼻炎的鼻部症状。针对对照试验的荟萃分析结果显示，孟鲁司特联合左西替利嗪组的鼻症状评分标准化均数差（Standardized Mean Difference, SMD）为-2.56（95%置信区间：-2.77至-2.35），提示相较于对照组，孟鲁司特联合左西替利嗪可显著改善变应性鼻炎症状。综上，本荟萃分析证实孟鲁司特联合左西替利嗪可有效改善伴哮喘变应性鼻炎的鼻部症状，表明该联合用药方案在改善变应性鼻炎症状方面优于单一用药，且安全性良好。