We performed a systematic review and meta-analysis of randomized controlled trials to compare the efficacy of 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 original articles. We used a random-effects model for the meta-analysis to determine the mean difference in the nasal symptom scores between the LTRA and INCS groups. Statistical heterogeneity was assessed using the I2 statistic and chi-squared test. A subgroup analysis was performed using the sample size, treatment duration, and comorbidities. We performed a database 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 to 16.12). The results showed moderate heterogeneity (I2=33%, P=0.20). In the subgroup analysis, the results were homogenous, although some showed heterogeneity and some of the differences between the treatments were not statistically significant. There was moderate heterogeneity in the subgroup analysis (I2=63%, P=0.07), owing to the small sample size (n<600). The results of the study with a long treatment duration (more than 15 days) and those of the studies including patients with asthma were that the difference in the efficacy of INCS treatment and that of LTRA treatment was not 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 between the two treatments, the subgroup analysis consistently showed the superiority of INCS in treating patients with AR.
Introduction
Methods
Results and Discussion
Conclusion
Acknowledgment
Conflict of Interest
References