Leukotriene receptor antagonists in the treatment of allergic rhinitis

OBJECTIVE: To review the literature examining the clinical use of leukotrie ne receptor antagonists in the treatment of allergic rhinitis. DATA SOURCES: Biomedical literature accessed through MEDLINE (1990-November 2000) and Current Contents (week 35 of 1999 to week 48 of 2000). Key terms included leukotriene antagonists, montelukast, zafirlukast, and rhinitis ( allergic). DATA SYNTHESIS: Preliminary evidence on the clinical use of either monteluk ast or zafirlukast as monotherapy is equivocal, with one study noting benef it and another noting lack of benefit in symptom amelioration. A third stud y suggests that these agents may have a role in further modifying allergic rhinitis symptoms when used in combination with standard treatments. CONCLUSIONS: Future large-scale studies should assess the efficacy of these agents in the treatment of allergic rhinitis, in particular, to identify s ubsets of patients likely to derive the most benefit. Available data sugges t it is reasonable and safe to add these agents to standard therapy if symp tomatology remains unresolved.