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KMID : 0370220220660010041
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Yakhak Hoeji
2022 Volume.66 No. 1 p.41 ~ p.47
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Comparing the Efficacy of Leukotriene Receptor Antagonists and Intra-nasal Steroids in the Treatment of Allergic Rhinitis: A Systematic Review and Meta-analysis
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Lee Da-Mi
Kim Si-In
Suh Hae-Sun
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Abstract
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We performed a systematic review and meta-analysis of randomized controlled trials to compare the efficacyof leukotriene receptor antagonists (LTRAs) and intranasal corticosteroids (INCSs) in patients with allergic rhinitis (AR).
We searched OVID-MEDLINE (1946 to November 6, 2020), EMBASE, and the Cochrane Library databases for originalarticles. We used a random-effects model for the meta-analysis to determine the mean difference in the nasal symptomscores between the LTRA and INCS groups. Statistical heterogeneity was assessed using the I2 statistic and chi-squaredtest. A subgroup analysis was performed using the sample size, treatment duration, and comorbidities. We performed adatabase search on November 6, 2020, which yielded 922 reports. Of these, five studies were included in the metaanalysis.
INCS treatment was more effective than LTRA treatment in relieving the nasal symptom of patients with AR(weighted mean difference [WMD] of the total nasal symptom score change=10.77, 95% confidence interval [CI]: 5.41 to16.12). The results showed moderate heterogeneity (I2=33%, P=0.20). In the subgroup analysis, the results werehomogenous, although some showed heterogeneity and some of the differences between the treatments were notstatistically significant. There was moderate heterogeneity in the subgroup analysis (I2=63%, P=0.07), owing to the smallsample size (n<600). The results of the study with a long treatment duration (more than 15 days) and those of the studiesincluding patients with asthma were that the difference in the efficacy of INCS treatment and that of LTRA treatment wasnot statistically significant (WMD=3.86, 95% CI: ?5.8 to 13.52; and WMD=8.18, 95% CI: ?0.29 to 16.65, respectively).
Although some of the subgroups showed heterogeneity and did not demonstrate statistically significant differences betweenthe two treatments, the subgroup analysis consistently showed the superiority of INCS in treating patients with AR.
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KEYWORD
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Allergic rhinitis, Leukotriene receptor antagonists, Intranasal steroids
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