Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
OBJECTIVE: The objective of this selective EBM review is to determine whether or not montelukast as a monotherapy is effective in relieving daytime nasal symptoms in individuals diagnosed with allergic rhinitis.
STUDY DESIGN: A systemic review of three primary randomized controlled trials (RCTs) published in peer-review journals in 2018. All articles were published in the English language.
DATA SOURCES: One single-center, randomized, open-label study; one randomized, multicenter, double-blinded, phase III trial study; and one double-blinded, randomized, parallelgroup, comparative study evaluating if montelukast taken as monotherapy can improve daytime nasal symptoms in individuals with allergic rhinitis. Sources were selected from Google Scholar and PubMed to answer the clinical question and all contained patient-oriented outcomes.
OUTCOMES MEASURED: The outcome measured was the relief of daytime nasal symptoms in individuals with allergic rhinitis using visual analog scales, self-reported diary entries, and patient questionnaire forms that were filled out at subsequent visits.
RESULTS: The study that was conducted by Bylappa and Delphine (Int J Otorhinolaryngol. 2018;4(2):467-472. Doi: 10.18203/issn.2454-5929.ijohns2018070) showed statistically significant daytime nasal symptom relief in montelukast therapy (p=0.005). The study conducted by Chen, Wang, Cao, et al. (Int Forum Allergy Rhinol. 2018;8(11). Doi:10.1002/alr.22197) showed statistically significant improvements in daytime nasal symptoms in at least 50% of patients after two weeks of montelukast therapy (p=0.001). The study of Park J, Park C, Cho, et al. (Chest. 2018;40(7). Doi: 10.1026/j.cest.2018.08.1013) showed statistically significant improvement of daytime nasal symptom relief with montelukast therapy as well (p=0.045).
CONCLUSION: The articles that were analyzed in this EBM review shows that montelukast as a monotherapy can improve daytime nasal symptoms in patients with allergic rhinitis. All three studies yielded statistically significant results. However, due to the limitations of all three studies such as small sample size, short trial period, open-label trial, and no intention to treat analysis, more research is needed in order to determine the validity of montelukast as a treatment of choice to relieve daytime nasal symptoms in patients with allergic rhinitis.
Ngan, Linh, "Is Taking Montelukast as Monotherapy Effective in Relieving Daytime Nasal Symptoms in Individuals with Allergic Rhinitis?" (2020). PCOM Physician Assistant Studies Student Scholarship. 564.