Evidence map›Paper›PMID 40664175›Full record

SynthesisInternational archives of allergy and immunology2026

Comparative Efficacy of Montelukast-Levocetirizine Combination Therapy versus Monotherapy in Allergic Rhinitis: A Systematic Review and Meta-Analysis.

Ji-Sun Kim, Gulnaz Stybayeva, Se Hwan Hwang

Abstract readSystematic ReviewMeta-AnalysisComparative Study
In one paragraph

Synthesis in International archives of allergy and immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Ji-Sun KimDepartment of Otolaryngology-Head and Neck Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Gulnaz StybayevaDepartment of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA.
Se Hwan HwangDepartment of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea, yellobird@catholic.ac.kr.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

<p>Introduction: Combination therapy with antihistamines and leukotriene receptor antagonists (LTRAs) is frequently used in allergic rhinitis (AR), particularly in patients with persistent or inadequately controlled symptoms. However, supporting evidence has been inconsistent. This meta-analysis assessed the efficacy of montelukast combined with levocetirizine in patients with AR by directly comparing the combination therapy with each monotherapy and evaluating individual symptom domains.

methodsA systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted, with database searches performed through March 2025. Outcomes included daytime and nighttime total symptom scores, individual nasal symptoms, rhinoconjunctivitis-related quality of life (RQLQ), and treatment-emergent adverse events (TEAEs). Pooled effects were calculated using standardized mean differences (SMDs) and odds ratios (ORs) with 95% confidence intervals (CIs).

resultsSeven RCTs (n = 887) were included. Combination therapy resulted in greater improvement in daytime symptoms (SMD [95% CI]: -0.42 [-0.64 to -0.20]), rhinorrhea (SMD [95% CI]: -0.69 [-1.09 to -0.30]), and nasal congestion (SMD [95% CI]: -0.64 [-1.05 to -0.24]) compared to monotherapy. RQLQ scores improved modestly overall (SMD [95% CI]: -0.37 [-0.72 to -0.01]), but subgroup analyses showed no significant difference compared to individual agents. TEAE rates were similar across groups (OR [95% CI]: 1.05 [0.57 to 1.94]).

conclusionMontelukast-levocetirizine combination therapy provided superior symptom control without increased adverse events, supporting its use as a potential treatment option in selected patients with AR. </p>.

Indexed as

AcetatesCetirizineCyclopropanesLeukotriene AntagonistsQuinolinesRhinitis, AllergicSulfidesDrug Therapy, CombinationHistamine H1 Antagonists, Non-SedatingHumansQuality of LifeRandomized Controlled Trials as TopicTreatment OutcomeAcetatesCetirizineCyclopropanesHistamine H1 Antagonists, Non-SedatingLeukotriene AntagonistslevocetirizinemontelukastQuinolinesSulfidesAllergic rhinitisCombination therapyHistamine antagonistsLeukotriene antagonistsMeta-analysis

Identifiers

PMID40664175
PMCPMC12503583

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.