Skip to main content
SpringerLink
Log in

Montelukast in the Treatment of Allergic Rhinitis

An Evidence-Based Review

  • Review Article
  • Published:
Drugs Aims and scope Submit manuscript

Abstract

Cysteinyl-leukotrienes (CysLTs) are endogenous mediators of inflammation and play an important role in allergic airway disease by stimulating bronchoconstriction, mucus production, mucosal oedema and inflammation, airway infiltration by eosinophils, and dendritic cell maturation that prepares for future allergic response. Montelukast inhibits these actions by blocking type 1 CysLT receptors found on immunocytes, smooth muscle and endothelium in the respiratory mucosa. Initially developed as a treatment for asthma, montelukast has more recently found use in the treatment of allergic rhinitis (AR).

We conducted a systematic review of studies that have evaluated montelukast in the treatment of seasonal AR (SAR) and perennial AR (PAR), with and without concomitant asthma. Primary consideration was given to large, randomised, placebo-controlled, double-blind clinical trials in which AR endpoints were assessed and the use of concurrent treatments for AR was excluded. Eight such studies were found in the literature. The primary endpoint in these was daytime nasal symptom severity represented by a composite score derived from individual self-ratings of nasal congestion, rhinorrhoea, nasal pruritus and sneezing. Secondary endpoints have included these individual nasal symptom scores, additional scores for eye, ear and throat symptoms, the impact of rhinitis on quality of sleep, global evaluations of outcome by patients and physicians, and measures of the severity of concomitant asthma.

A general outcome was that patients treated with montelukast had significantly greater improvements in their symptoms of SAR and PAR than did patients who were given a placebo. As monotherapy, montelukast exhibited efficacy similar to that of loratadine, but less than that of the intranasally administered corticosteroid fluticasone propionate. The use of montelukast in combination with antihistamines such as loratadine or cetirizine has generally resulted in greater efficacy than when these agents were used alone, and in some studies has produced results comparable with intranasally applied corticosteroids. In patients with AR comorbid with asthma, montelukast treatment has resulted in significant improvements in both, compared with placebo. Montelukast is well tolerated and has a favourable safety profile; adverse events have occurred at similar frequencies in patients taking either montelukast or placebo.

Montelukast provides an effective and well tolerated oral treatment for allergic airway inflammation in patients with SAR or PAR without asthma, and in patients in whom AR is comorbid with asthma.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Table I
Table II

Similar content being viewed by others

References

  1. Labelle M, Belley M, Gareau Y, et al. Discovery of MK-0476, a potent and orally active leukotriene D4 receptor antagonist devoid of peroxisomal enzyme induction. Bioorg Med Chem Lett 1995; 5: 283–8

    Article  CAS  Google Scholar 

  2. Creticos PS, Peters SP, Adkinson NF Jr, et al. Peptide leukotriene release after antigen challenge in patients sensitive to ragweed. N Engl J Med 1984; 310: 1626–30

    Article  PubMed  CAS  Google Scholar 

  3. Volovitz B, Osur SL, Bernstein JM, et al. Leukotriene C4 release in upper respiratory mucosa during natural exposure to ragweed in ragweed-sensitive children. J Allergy Clin Immunol 1988; 82: 414–8

    Article  PubMed  CAS  Google Scholar 

  4. Dahlén SE, Hedqvist P, Hammarstrom S, et al. Leukotrienes are potent constrictors of human bronchi. Nature 1980; 288: 484–6

    Article  PubMed  Google Scholar 

  5. Laitinen LA, Laitinen A, Haahtela T, et al. Leukotriene E4 and granulocytic infiltration into asthmatic airways. Lancet 1993; 341: 989–90

    Article  PubMed  CAS  Google Scholar 

  6. Kanaoka Y, Boyce JA. Cysteinyl leukotrienes and their receptors: cellular distribution and function in immune and inflammatory responses. J Immunol 2004; 173: 1503–10

    PubMed  CAS  Google Scholar 

  7. Peters-Golden M, Henderson WR Jr. The role of leukotrienes in allergic rhinitis. Ann Allergy Asthma Immunol 2005; 94: 609–18

    Article  PubMed  CAS  Google Scholar 

  8. Robbiani DF, Finch RA, Jager D, et al. The leukotriene C (4) transporter MRP1 regulates CCL19 (MIP-3beta, ELQ-dependent mobilization of dendritic cells to lymph nodes. Cell 2000; 103: 757–6

    Article  PubMed  CAS  Google Scholar 

  9. Machida I, Matsuse H, Kondo Y, et al. Cysteinyl leukotrienes regulate dendritic cell functions in a murine model of asthma. J Immunol 2004; 172: 1833–8

    PubMed  CAS  Google Scholar 

  10. Thivierge M, Stankova J, Rola-Pleszczynski M. Toll-like receptor agonists differentially regulate cysteinyl-leukotriene receptor 1 expression and function in human dendritic cells. J Allergy Clin Immunol 2006; 117: 1155–62

    Article  PubMed  CAS  Google Scholar 

  11. Jarvis B, Markham A. Montelukast: a review of its therapeutic potential in persistent asthma. Drugs 2000; 59: 891–928

    Article  PubMed  CAS  Google Scholar 

  12. Korenblat PE, Antileukotriene Working Group. The role of antileukotrienes in the treatment of asthma. Ann Allergy Asthma Immunol 2001; 86 Suppl. 1: 31–9

    Article  PubMed  CAS  Google Scholar 

  13. Meltzer EO. Clinical evidence for antileukotriene therapy in the management of allergic rhinitis. Ann Allergy Asthma Immunol 2002; 88: 23–9

    Article  PubMed  Google Scholar 

  14. Nathan RA. Pharmacotherapy for allergic rhinitis: a critical review of leukotriene receptor antagonists compared with other treatments. Ann Allergy Asthma Immunol 2003; 90: 182–90

    Article  PubMed  CAS  Google Scholar 

  15. Portnoy JM, Van Osdol T, Williams PB. Evidence-based strategies for treatment of allergic rhinitis. Curr Allergy Asthma Rep 2004; 4: 439–46

    Article  PubMed  Google Scholar 

  16. Nayak A. A review of montelukast in the treatment of asthma and allergic rhinitis. Expert Opin Pharmacother 2004; 5: 679–86

    Article  PubMed  CAS  Google Scholar 

  17. Wilson AM, O’Byrne PM, Parameswaran K. Leukotriene receptor antagonists for allergic rhinitis: a systematic review and meta-analysis. Am J Med 2004; 116: 338–44

    Article  PubMed  CAS  Google Scholar 

  18. Rodrigo GH, Yanez A. The role of antileukotriene therapy in seasonal allergic rhinitis: a systematic review of randomized trials. Ann Allergy Asthma Immunol 2006; 96: 779–86

    Article  PubMed  CAS  Google Scholar 

  19. Dahlén S-E. Cysteinyl leukotrienes as common mediators of asthma and allergic disease. Clin Exp Allergy Rev 2003; 3: 69–73

    Article  Google Scholar 

  20. Luskin A, Bukstein D, Kocevar VS, et al. Asthma rescue and allergy medication use among asthmatic children with prior allergy prescriptions who initiated asthma controller therapy. Ann Allergy Asthma Immunol 2005; 95: 129–36

    Article  PubMed  Google Scholar 

  21. Crown WH, Olufade A, Smith MW, et al. Seasonal versus perennial allergic rhinitis: drug and medical resource use patterns. Value Health 2003; 6: 448–56

    Article  PubMed  Google Scholar 

  22. Meltzer EO, Malmstrom K, Lu S, et al. Concomitant montelukast and loratadine as treatment for seasonal allergic rhinitis: a randomized, placebo-controlled clinical trial. J Allergy Clin Immunol 2000; 105: 917–22

    Article  PubMed  CAS  Google Scholar 

  23. Nayak AS, Philip G, Lu S, et al. Efficacy and tolerability of montelukast alone or in combination with loratadine in seasonal allergic rhinitis: a multicenter, randomized, double-blind, placebo-controlled trial performed in the fall. Ann Allergy Asthma Immunol 2002; 88: 592–600

    Article  PubMed  CAS  Google Scholar 

  24. Philip G, Malmstrom K, Hampel FC, et al. Montelukast for treating seasonal allergic rhinitis: a randomized, double-blind, placebo-controlled trial performed in the spring. Clin Exp Allergy 2002; 32: 1020–8

    Article  PubMed  CAS  Google Scholar 

  25. van Adelsberg J, Philip G, LaForce CF, et al. Randomized controlled trial evaluating the clinical benefit of montelukast for treating spring seasonal allergic rhinitis. Ann Allergy Asthma Immunol 2003; 90: 214–22

    Article  PubMed  Google Scholar 

  26. van Adelsberg J, Philip G, Pedinoff AJ, et al. Montelukast improves symptoms of seasonal allergic rhinitis over a 4-week treatment period. Allergy 2003; 58: 1268–76

    Article  PubMed  Google Scholar 

  27. Philip G, Nayak AS, Berger WE, et al. The effect of montelukast on rhinitis symptoms in patients with asthma and seasonal allergic rhinitis. Curr Med Res Opin 2004; 20: 1549–58

    Article  PubMed  CAS  Google Scholar 

  28. Nathan RA, Yancey SW, Waitkus-Edwards K, et al. Fluticasone propionate nasal spray is superior to montelukast for allergic rhinitis while neither affects overall asthma control. Chest 2005; 128: 1910–20

    Article  PubMed  CAS  Google Scholar 

  29. Patel P, Philip G, Yang W, et al. Randomized, double-blind, placebo-controlled study of montelukast for treating perennial allergic rhinitis. Ann Allergy Asthma Immunol 2005; 95: 551–7

    Article  PubMed  Google Scholar 

  30. Demoly P, Bozonnat MC, Dacosta P, et al. The diagnosis of asthma using a self-questionnaire in those suffering from allergic rhinitis: a pharmaco-epidemiological survey in everyday practice in France. Allergy 2006; 61: 699–704

    Article  PubMed  CAS  Google Scholar 

  31. Gaugris S, Sazonov-Kocevar V, Thomas M. Burden of concomitant allergic rhinitis in adults with asthma. J Asthma 2006; 43: 1–7

    Article  PubMed  Google Scholar 

  32. Juniper EF, Thompson AK, Ferrie PJ, et al. Validation of the standardized version of the Rhinoconjunctivitis Quality of Life Questionnaire. J Allergy Clin Immunol 1999; 104: 364–9

    Article  PubMed  CAS  Google Scholar 

  33. Meltzer EO, Philip G, Weinstein SF, et al. Montelukast effectively treats the nighttime impact of seasonal allergic rhinitis. Am J Rhinol 2005; 19: 591–8

    PubMed  Google Scholar 

  34. Weinstein SF, Philip G, Hampel FC Jr, et al. Onset of efficacy of montelukast in seasonal allergic rhinitis. Allergy Asthma Proc 2005; 26: 41–6

    PubMed  CAS  Google Scholar 

  35. Hsieh JC, Lue KH, Lai DS, et al. A comparison of cetirizine and montelukast for treating childhood perennial allergic rhinitis. Pediatr Asthma Allergy Immunol 2004; 17: 59–69

    Article  Google Scholar 

  36. Chen ST, Lu KH, Sun HL, et al. Randomized placebo-controlled trial comparing montelukast and cetirizine for treating perennial allergic rhinitis in children aged 2–6 yr. Pediatr Allergy Immunol 2006; 17: 49–54

    Article  PubMed  Google Scholar 

  37. Mucha SM, deTineo M, Naclerio RM, et al. Comparison of montelukast and pseudoephedrine in the treatment of allergic rhinitis. Arch Otolaryngol Head Neck Surg 2006; 132: 164–72

    Article  PubMed  Google Scholar 

  38. Wilson AM, Orr LC, Sims EJ, et al. Effects of monotherapy with intra-nasal corticosteroid or combined oral histamine and leukotriene receptor antagonists in seasonal allergic rhinitis. Clin Exp Allergy 2001; 31: 61–8

    PubMed  CAS  Google Scholar 

  39. Wilson AM, Sims EJ, Orr LC, et al. Effects of topical corticosteroid and combined mediator blockade on domiciliary and laboratory measurements of nasal function in seasonal allergic rhinitis. Ann Allergy Asthma Immunol 2001; 87: 344–9

    Article  PubMed  CAS  Google Scholar 

  40. Wilson AM, Orr LC, Coutie WJ, et al. A comparison of once daily fexofenadine versus the combination of montelukast plus loratadine on domiciliary nasal peak flow and symptoms in seasonal allergic rhinitis. Clin Exp Allergy 2002; 32: 126–32

    Article  PubMed  CAS  Google Scholar 

  41. Pullerits T, Praks L, Ristioja V, et al. Comparison of a nasal glucocorticoid, antileukotriene, and a combination of antileukotriene and antihistamine in the treatment of seasonal allergic rhinitis. J Allergy Clin Immunol 2002; 109: 949–55

    Article  PubMed  CAS  Google Scholar 

  42. Ratner PH, Howland WC III, Arastu R, et al. Fluticasone propionate aqueous nasal spray provided significantly greater improvement in daytime and nighttime nasal symptoms of seasonal allergic rhinitis compared with montelukast. Ann Allergy Asthma Immunol 2003; 90: 536–42

    Article  PubMed  CAS  Google Scholar 

  43. Saengpanich S, deTineo M, Naclerio RM, et al. Fluticasone nasal spray and the combination of loratadine and montelukast in seasonal allergic rhinitis. Arch Otolaryngol Head Neck Surg 2003; 129: 557–62

    Article  PubMed  Google Scholar 

  44. Di Lorenzo G, Pacor ML, Pellitteri ME, et al. Randomized placebo-controlled trial comparing fluticasone aqueous nasal spray in mono-therapy, fluticasone plus cetirizine, fluticasone plus montelukast and cetirizine plus montelukast for seasonal allergic rhinitis. Clin Exp Allergy 2004; 34: 259–67

    Article  PubMed  Google Scholar 

  45. Kurowski M, Kuna P, Gorski P. Montelukast plus cetirizine in the prophylactic treatment of seasonal allergic rhinitis: influence on clinical symptoms and nasal allergic inflammation. Allergy 2004; 59: 280–8

    Article  PubMed  CAS  Google Scholar 

  46. Moinuddin R, deTineo M, Maleckar B, et al. Comparison of the combinations of fexofenadine-pseudoephedrine and loratadine-montelukast in the treatment of seasonal allergic rhinitis. Ann Allergy Asthma Immunol 2004; 92: 73–9

    Article  PubMed  CAS  Google Scholar 

  47. Ciebiada M, Gorska-Ciebiada M, DuBuske LM, et al. Montelukast with desloratadine or levocetirizine for the treatment of persistent allergic rhinitis. Ann Allergy Asthma Immunol 2006; 97: 664–71

    Article  PubMed  CAS  Google Scholar 

  48. Martin BG, Andrews CP, van Bavel JH, et al. Comparison of fluticasone propionate aqueous nasal spray and oral montelukast for the treatment of seasonal allergic rhinitis symptoms. Ann Allergy Asthma Immunol 2006; 96: 851–7

    Article  PubMed  CAS  Google Scholar 

  49. Razi C, Bakirtas A, Harmanci K, et al. Effect of montelukast on symptoms and exhaled nitric oxide levels in 7-to 14-year-old children with seasonal allergic rhinitis. Ann Allergy Asthma Immunol 2006; 97: 767–74

    Article  PubMed  CAS  Google Scholar 

  50. Barnes ML, Menzies D, Fardon TC, et al. Combined mediator blockade or topical steroid for treating the unified allergic airway. Allergy 2007; 62: 73–80

    Article  PubMed  CAS  Google Scholar 

  51. Price DB, Swern A, Tozzi CA, et al. Effect of montelukast on lung function in asthma patients with allergic rhinitis: analysis from the COMPACT trial. Allergy 2006; 61: 737–42

    Article  PubMed  CAS  Google Scholar 

  52. Settipane RJ, Hagy GW, Settipane GA, et al. Long-term risk factors for developing asthma and allergic rhinitis: a 23-year follow-up study of college students. Allergy Proc 1994; 15: 21–5

    Article  PubMed  CAS  Google Scholar 

  53. Leynaert B, Bousquet J, Neukirch C, et al. Perennial rhinitis: an independent risk factor for asthma in nonatopic subjects: results from the European Community Respiratory Health Survey. J Allergy Clin Immunol 1999; 104: 301–4

    Article  PubMed  CAS  Google Scholar 

  54. Guerra S, Sherrill DL, Martinez FD, et al. Rhinitis as an independent risk factor for adult-onset asthma. J Allergy Clin Immunol 2002; 109: 419–25

    Article  PubMed  Google Scholar 

  55. Polosa R, Al-Delaimy WK, Russo C, et al. Greater risk of incident asthma cases in adults with allergic rhinitis and effect of allergen immunotherapy: a retrospective cohort study. Respir Res 2005; 6: 153

    Article  PubMed  Google Scholar 

  56. Bousquet J, VanCauwenberge P, Khaltaev N. ARIA Workshop Group; World Health Organization. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol 2001; 108 (5 Suppl.): S147–334

    Article  PubMed  CAS  Google Scholar 

  57. Grossman J. One airway, one disease. Chest 1997; 111: 11–16S

    Article  Google Scholar 

  58. Simons FE. Allergic rhinobronchitis: the asthma-allergic rhinitis link. J Allergy Clin Immunol 1999; 104: 534–40

    Article  PubMed  CAS  Google Scholar 

  59. Casale TB, Amin BV. Allergic rhinitis/asthma interrelationships. Clin Rev Allergy Immunol 2001; 21: 27–49

    Article  PubMed  CAS  Google Scholar 

  60. Nayak AS. A common pathway: asthma and allergic rhinitis. Allergy Asthma Proc 2002; 23: 359–65

    PubMed  Google Scholar 

  61. Borish L. Allergic rhinitis: systemic inflammation and implications for management. J Allergy Clin Immunol 2003; 112: 1021–31

    Article  PubMed  CAS  Google Scholar 

  62. Braunstahl GJ. The unified immune system: respiratory tract-nasobronchial interaction mechanisms in allergic airway disease. J Allergy Clin Immunol 2005; 115: 142–8

    Article  PubMed  CAS  Google Scholar 

  63. Boulet LP, Turcotte H, Laprise C, et al. Comparative degree and type of sensitization to common indoor and outdoor allergens in subjects with allergic rhinitis and/or asthma. Clin Exp Allergy 1997; 27: 52–9

    Article  PubMed  CAS  Google Scholar 

  64. National Institutes of Health. National Institutes of Health Global Initiative for Asthma, Global Strategy for Asthma Management and Prevention: a pocket guide for physicians and nurses. Bethesda (MD): National Institutes of Health, 1998 [publication no. 95-3659B]

    Google Scholar 

  65. Togias A. Unique mechanistic features of allergic rhinitis. J Allergy Clin Immunol 2000; 105: S599–604

    Article  PubMed  CAS  Google Scholar 

  66. Varner AE, LemanskeJr RF. The early and late asthmatic response to allergen. In: Busse WW, Holgate ST, editors. Asthma and rhinitis. 2nd ed. Oxford: Blackwell Science, 2000: 1172–85

    Chapter  Google Scholar 

  67. Kay AB. Allergy and allergic diseases: first of two parts. N Engl J Med 2001; 344: 30–7

    Article  PubMed  CAS  Google Scholar 

  68. Gaga M, Lambrou P, Papageorgiou N, et al. Eosinophils are a feature of upper and lower airway pathology in non-atopic asthma, irrespective of the presence of rhinitis. Clin Exp Allergy 2000; 30: 663–9

    Article  PubMed  CAS  Google Scholar 

  69. Corren J, Adinoff AD, Irvin CG. Changes in bronchial responsiveness following nasal provocation with allergen. J Allergy Clin Immunol 1992; 89: 611–8

    Article  PubMed  CAS  Google Scholar 

  70. Braunstahl GJ, Kleinjan A, Overbeek SE, et al. Segmental bronchial provocation induces nasal inflammation in allergic rhinitis patients. Am J Respir Crit Care Med 2000; 161: 2051–7

    PubMed  CAS  Google Scholar 

  71. Braunstahl GJ, Overbeek SE, Fokkens WJ, et al. Segmental bronchoprovocation in allergic rhinitis patients affects mast cell and basophil numbers in nasal and bronchial mucosa. Am J Respir Crit Care Med 2001; 164: 858–65

    PubMed  CAS  Google Scholar 

  72. Failla M, Biondi G, Provvidenza Pistorio M, et al. Intranasal steroid reduces exhaled bronchial cysteinyl leukotrienes in allergic patients. Clin Exp Allergy 2006; 36: 325–30

    Article  PubMed  CAS  Google Scholar 

  73. Bousquet J, Gaugris S, Kocevar VS, et al. Increased risk of asthma attacks and emergency visits among asthma patients with allergic rhinitis: a subgroup analysis of the improving asthma control trial. Clin Exp Allergy 2005; 35: 723–7

    Article  PubMed  CAS  Google Scholar 

  74. Price DB, Zhang Q, Sazonov-Kocevar V, et al. Effect of a concomitant diagnosis of allergic rhinitis on asthma-related health care use by adults. Clin Exp Allergy 2005; 35: 282–7

    Article  PubMed  CAS  Google Scholar 

  75. Thomas M, Kocevar VS, Zhang Q, et al. Asthma-related health care resource use among asthmatic children with and without concomitant allergic rhinitis. Pediatrics 2005; 115: 129–34

    PubMed  Google Scholar 

  76. Corren J. The impact of allergic rhinitis on bronchial asthma. J Allergy Clin Immunol 1998; 101: S352–6

    Article  PubMed  CAS  Google Scholar 

  77. Settipane RA. Complications of allergic rhinitis. Allergy Asthma Proc 1999; 20: 209–13

    Article  PubMed  CAS  Google Scholar 

  78. Crystal-Peters J, Neslusan C, Crown WH, et al. Treating allergic rhinitis in patients with comorbid asthma: the risk of asthma-related hospitalizations and emergency department visits. J Allergy Clin Immunol 2002; 109: 57–62

    Article  PubMed  Google Scholar 

  79. Halpern MT, Schmier JK, Richner R, et al. Allergic rhinitis: a potential cause of increased asthma medication use, costs, and morbidity. J Asthma 2004; 41: 117–26

    Article  PubMed  Google Scholar 

  80. Busse WW, Casale TB, Dykewicz MS, et al. Efficacy of montelukast during the allergy season in patients with chronic asthma and seasonal aeroallergen sensitivity. Ann Allergy Asthma Immunol 2006; 96: 60–8

    Article  PubMed  CAS  Google Scholar 

  81. Virchow JC, Bachert C. Efficacy and safety of montelukast in adults with asthma and allergic rhinitis. Respir Med 2006 Nov; 100 (11): 1952–9

    Article  PubMed  Google Scholar 

  82. Bachert C, El-Akkad T. Patient preferences and sensory comparisons of three intranasal corticosteroids for the treatment of allergic rhinitis. Ann Allergy Asthma Immunol 2002; 89: 292–7

    Article  PubMed  Google Scholar 

  83. Skoner DP, Rachelefsky GS, Meltzer EO, et al. Detection of growth suppression in children during treatment with intranasal beclomethasone dipropionate [abstract]. Pediatrics 2000; 105: E23

    Article  PubMed  CAS  Google Scholar 

  84. Baena-Cagnani CE. Safety and tolerability of treatments for allergic rhinitis in children. Drug Saf 2004; 27: 883–98

    Article  PubMed  CAS  Google Scholar 

  85. Becker AB, Kuznetsova O, Vermeulen J, et al. Linear growth in prepubertal asthmatic children treated with montelukast, beclomethasone, or placebo: a 56-week randomized double-blind study. Ann Allergy Asthma Immunol 2006; 96: 800–7

    Article  PubMed  CAS  Google Scholar 

  86. Wechsler ME, Garpestad E, Flier SR, et al. Pulmonary infiltrates, eosinophilia, and cardiomyopathy following corticosteroid withdrawal in patients with asthma receiving zafirlukast. JAMA 1998; 279: 455–7

    Article  PubMed  CAS  Google Scholar 

  87. Le Gall C, Pham S, Vignes S, et al. Inhaled corticosteroids and Churg-Strauss syndrome: a report of five cases. Eur Respir J 2000; 15: 978–81

    Article  PubMed  Google Scholar 

  88. Weller PF, Plaut M, Taggart V, et al. The relationship of asthma therapy and Churg-Strauss syndrome: NIH workshop summary report. J Allergy Clin Immunol 2001; 108: 175–83

    Article  PubMed  CAS  Google Scholar 

  89. Michael AB, Murphy D. Montelukast-associated Churg-Strauss syndrome. Age Ageing 2003; 32: 551–2

    Article  PubMed  Google Scholar 

  90. Noth I, Strek ME, Leff AR. Churg-Strauss syndrome. Lancet 2003; 361: 587–94

    Article  PubMed  Google Scholar 

  91. Loughlin JE, Cole JA, Rothman KJ, et al. Prevalence of serious eosinophilia and incidence of Churg-Strauss syndrome in a cohort of asthma patients. Ann Allergy Asthma Immunol 2002; 88: 319–25

    Article  PubMed  Google Scholar 

  92. Lilly CM, Churg A, Lazarovich M, et al. Asthma therapies and Churg-Strauss syndrome. J Allergy Clin Immunol 2002; 109: S1–19

    Article  PubMed  Google Scholar 

  93. Song F, Eastwood AJ, Gilbody S, et al. Publication and related biases. Health Technol Assess 2000; 4: 1–115

    Google Scholar 

  94. Akerlund A, Andersson M, Leflein J, et al. Clinical trial design, nasal allergen challenge models, and considerations of relevance to pediatrics, nasal polyposis, and different classes of medication. J Allergy Clin Immunol 2005; 115: S460–82

    Article  PubMed  Google Scholar 

  95. Morton V, Torgerson DJ. Regression to the mean: treatment effect without the intervention. J Eval Clin Pract 2005; 11: 59–65

    Article  PubMed  Google Scholar 

  96. Benedetti F, Mayberg HS, Wager TD, et al. Neurobiological mechanisms of the placebo effect. J Neurosci 2005; 25: 10390–402

    Article  PubMed  CAS  Google Scholar 

  97. Frenz DA. Interpreting atmospheric pollen counts for use in clinical allergy: allergic symptomology. Ann Allergy Asthma Immunol 2001; 86: 150–7

    Article  PubMed  CAS  Google Scholar 

  98. Chervinsky P, Philip G, Malice MP, et al. Montelukast for treating fall allergic rhinitis: effect of pollen exposure in 3 studies. Ann Allergy Asthma Immunol 2004; 92: 367–73

    Article  PubMed  CAS  Google Scholar 

  99. Knorr B, Franchi LM, Bisgaard H, et al. Montelukast, a leukotriene receptor antagonist, for the treatment of persistent asthma in children aged 2 to 5 years. Pediatrics 2001; 108: E48

    Article  PubMed  CAS  Google Scholar 

  100. Storms W, Michele TM, Knorr B, et al. Clinical safety and tolerability of montelukast, a leukotriene receptor antagonist, in controlled clinical trials in patients aged ≥6 years. Clin Exp Allergy 2001; 31: 77–87

    Article  PubMed  CAS  Google Scholar 

  101. Knorr B, Maganti L, Ramakrishnan R, et al. Pharmacokinetics and safety of montelukast in children aged 3 to 6 months. J Clin Pharmacol 2006; 46: 620–7

    Article  PubMed  CAS  Google Scholar 

  102. Jones C, Santanello NC, Boccuzzi SJ, et al. Adherence to prescribed treatment for asthma: evidence from pharmacy benefits data. J Asthma 2003; 40: 93–101

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Dr Anjuli Nayak has received research grants, educational support, honoraria and/or consultancy fees from the following pharmaceutical companies involved in the manufacture and sale of drugs that are evaluated in this article: AstraZeneca, GlaxoSmithKline, Merck & Co., Pfizer, Schering-Plough, and Wyeth. Dr Ronald B. Langdon is an employee of Merck & Co.

Author information

Authors and Affiliations

  1. Sneeze, Wheeze & Itch Associates, LLC, 2010 Jacobssen Drive, Normal, Illinois, 61761, USA

    Anjuli Nayak

  2. Merck Research Laboratories, Rahway, New Jersey, USA

    Ronald B. Langdon

Authors
  1. Anjuli Nayak
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ronald B. Langdon
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anjuli Nayak.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nayak, A., Langdon, R.B. Montelukast in the Treatment of Allergic Rhinitis. Drugs 67, 887–901 (2007). https://doi.org/10.2165/00003495-200767060-00005

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00003495-200767060-00005

Keywords

Search

Navigation