Effects of montelukast on allergic rhinitis in children: a systematic review and meta-analysis.

OBJECTIVE

To systematically evaluate the efficacy and safety of montelukast in the treatment of allergic rhinitis (AR) in children through a meta-analysis.

METHODS

Pubmed, Embase, and Cochrane Library were retrieved for randomized controlled trials and cohort studies on montelukast for pediatric AR from databases inception to June 2025. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias. Meta-analysis was conducted using RevMan5.3. Effect size was expressed as weighted mean difference (WMD) or odds ratio (OR) with 95% confidence interval (CI).

RESULT: A total of 14 studies were included. Those treated with non-montelukast regimens were set as Group A, and those treated with montelukast were set as Group B. Meta-analysis showed that the total effective rate in group B was significantly higher than that in group A [OR=0.32 (0.20, 0.50), P<0.001]. The reduction in the Total Nasal Symptom Score (TNSS) was significantly greater in group B [WMD=0.83 (0.13, 1.54), P=0.02]. There was no significant difference in the incidence of adverse reactions between the two groups [OR=1.00 (0.71, 1.39), P=0.98]. In addition, no significant differences were observed between the two groups in immunoglobulin E (IgE) levels and the percentage of eosinophils (EOS).

CONCLUSION

Montelukast improves the total effective rate and clinical symptoms of pediatric AR with a favorable safety profile.