{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T02:45:32Z","timestamp":1790045132950,"version":"4.0.1"},"reference-count":33,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2019,4,22]],"date-time":"2019-04-22T00:00:00Z","timestamp":1555891200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Rhinol\ufffdAllergy"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Histamine and leukotriene are released after being triggered by allergen exposure. The combination of leukotriene receptor antagonist (LTRA) and H1-antihistamine (AH) is utilized to control the allergic rhinitis (AR) symptoms after the failure of either AH or LTRA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to investigate the effects of the combination of H1-antihistamine and leukotriene receptor antagonist (AH-LTRA) in patients with AR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Randomized controlled trials studying the effects of AH-LTRA versus AH alone on rhinoconjuncitivits symptoms in patients with AR were included. Data were pooled for meta-analysis. The outcomes were nasal symptoms, ocular symptoms, disease-specific quality of life, and adverse events. Meta-analyses were performed to compare the outcomes between AH-LTRA and AH. Subgroup analyses by AR subtype, asthma, and pediatric patients were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fourteen studies (3271 participants) met the inclusion criteria. The results favored the effects of AH-LTRA on (1) composite nasal symptom score (standardized mean difference [SMD]: \u22120.20; 95% confidence interval [CI]: \u22120.36, \u22120.03), (2) rhinorrhea (SMD: \u22120.14; 95% CI: \u22120.27, \u22120.02), and (3) sneezing (SMD: \u22120.15; 95% CI: \u22120.27, \u22120.02). Subgroup analyses revealed that results favored the effects of AH-LTRA for perennial AR (SMD: \u22120.57; 95% CI: \u22120.87, \u22120.26) but not in the seasonal AR subgroup (SMD: \u22120.09; 95% CI: \u22120.21, 0.04), P\u2009=\u2009.004. There were no differences between AH-LTRA and AH on nasal obstruction, itching, ocular symptoms, Rhinoconjunctivitis Quality of life Questionnaire and adverse events. Due to limited number of included studies, effects on asthma and pediatric subgroups could not be assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>For controlling rhinoconjunctivitis symptoms in patients with AR, AH-LTRA provided greater beneficial effects on composite nasal symptoms, rhinorrhea, and sneezing compared to AH alone. These effects were shown in patients with perennial AR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1945892419844459","type":"journal-article","created":{"date-parts":[[2019,4,22]],"date-time":"2019-04-22T05:42:36Z","timestamp":1555911756000},"page":"591-600","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":22,"title":["Leukotriene Receptor Antagonist Addition to H1-Antihistamine Is Effective for Treating Allergic Rhinitis: A Systematic Review and Meta-analysis"],"prefix":"10.1177","volume":"33","author":[{"given":"Kachorn","family":"Seresirikachorn","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"},{"name":"Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wirach","family":"Chitsuthipakorn","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Rajavithi Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dichapong","family":"Kanjanawasee","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"},{"name":"Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Likhit","family":"Khattiyawittayakun","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"},{"name":"Department of Otolaryngology, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kornkiat","family":"Snidvongs","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"},{"name":"Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,4,22]]},"reference":[{"key":"bibr1-1945892419844459","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)62138-2"},{"key":"bibr2-1945892419844459","doi-asserted-by":"publisher","DOI":"10.1007\/164_2017_18"},{"key":"bibr3-1945892419844459","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)09019-9"},{"key":"bibr4-1945892419844459","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.1986.tb01960.x"},{"key":"bibr5-1945892419844459","first-page":"537","volume":"60","author":"Okuda M","year":"1988","journal-title":"Ann Allergy"},{"key":"bibr6-1945892419844459","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2007.01620.x"},{"key":"bibr7-1945892419844459","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814561600"},{"key":"bibr8-1945892419844459","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"bibr9-1945892419844459","unstructured":"Higgins JPT, Green S. 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