Inconsistencies remain regarding the effectiveness and safety of leukotriene receptor antagonists (LTRAs) and selective H1-antihistamines (SAHs) for allergic rhinitis (AR). A meta-analysis of randomized controlled trials (RCTs) was conducted to compare the medications. Relevant head-to-head comparative RCTs were retrieved by searching the PubMed, Embase, and Cochrane’s Library databases from inception to April 20, 2020. A random-effects model was applied to pool the results. Subgroup analyses were performed for seasonal and perennial AR. Fourteen RCTs comprising 4458 patients were included. LTRAs were inferior to SAHs in terms of the daytime nasal symptoms score (mean difference [MD]: 0.05, 95% confidence interval [CI] 0.02 to 0.08, p = 0.003, I2 = 89%) and daytime eye symptoms score (MD: 0.05, 95% CI 0.01 to 0.08, p = 0.009, I2 = 89%), but were superior in terms of the nighttime symptoms score (MD: − 0.04, 95% CI − 0.06 to − 0.02, p < 0.001, I2 = 85%). The effects of the two treatments on the composite symptom score (MD: 0.02, 95% CI − 0.02 to 0.05, p = 0.30, I2 = 91%) and rhinoconjunctivitis quality-of-life questionnaire (RQLQ) (MD: 0.01, 95% CI − 0.05 to 0.07, p = 0.71, I2 = 99%) were similar. Incidences of adverse events were comparable (odds ratio [OR]: 0.97, 95% CI 0.75 to 1.25, p = 0.98, I2 = 0%). These results were mainly obtained from studies on seasonal AR. No significant publication bias was detected. Although both treatments are safe and effective in improving the quality of life (QoL) in AR patients, LTRAs are more effective in improving nighttime symptoms but less effective in improving daytime nasal symptoms compared to SAHs.

中文翻译：

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用白三烯受体拮抗剂与选择性 H1-抗组胺药治疗过敏性鼻炎：对当前证据的荟萃分析

白三烯受体拮抗剂 (LTRA) 和选择性 H1-抗组胺药 (SAH) 治疗过敏性鼻炎 (AR) 的有效性和安全性仍存在不一致。进行了随机对照试验 (RCT) 的荟萃分析以比较药物。通过在 PubMed、Embase 和 Cochrane 图书馆数据库中搜索从开始到 2020 年 4 月 20 日的相关头对头比较 RCT。应用随机效应模型来汇总结果。对季节性和常年性 AR 进行了亚组分析。包括 4458 名患者的 14 项 RCT。在日间鼻部症状评分（平均差 [MD]：0.05，95% 置信区间 [CI] 0.02 至 0.08，p = 0.003，I2 = 89%）和日间眼部症状评分（MD： 0.05, 95% CI 0.01 至 0.08, p = 0.009, I2 = 89%), 但在夜间症状评分方面更胜一筹（MD：- 0.04，95% CI - 0.06 至 - 0.02，p < 0.001，I2 = 85%）。两种治疗对综合症状评分（MD：0.02，95% CI − 0.02 至 0.05，p = 0.30，I2 = 91%）和鼻结膜炎生活质量问卷（RQLQ）（MD：0.01，95）的影响% CI - 0.05 到 0.07，p = 0.71，I2 = 99%) 是相似的。不良事件的发生率具有可比性（优势比 [OR]：0.97，95% CI 0.75 至 1.25，p = 0.98，I2 = 0%）。这些结果主要来自对季节性 AR 的研究。未检测到显着的发表偏倚。尽管这两种治疗在改善 AR 患者的生活质量 (QoL) 方面都是安全有效的，但与 SAH 相比，LTRA 在改善夜间症状方面更有效，但在改善白天鼻部症状方面效果较差。