Leukotriene Antagonists in Nasal Polyposis: A Meta-analysis and Systematic Review
Open accessAbstract
Background Leukotriene antagonists (LTAs) provide a potential strategy for the management of chronic rhinosinusitis with nasal polyposis (CRSwNP), which is often refractory to medical and surgical treatment. The purpose of this study is to determine the impact of LTA treatment alone and in conjunction with intranasal corticosteroids (INCSs) on nasal symptoms, objective clinical outcomes, and immune parameters in CRSwNP. Methods A systematic review was performed including studies that assessed the effectiveness of LTAs on clinical outcome measures of CRSwNP. Exclusion criteria were trials assessing LTAs in CRS without nasal polyps or asthma symptoms only. Quantitative analysis was performed using a random effects model. Results Twelve studies fulfilled eligibility: five randomized control trials and seven case series. LTAs showed significant improvements in CRSwNP symptoms over placebo; however, these randomized trials were unable to be combined via meta-analysis. The two studies used in meta-analysis showed a standardized mean difference of pooled overall symptom scores of 0.02 (95% confidence interval, -0.39-0.44) between LTA and INCS study arms, indicating no difference between the treatment modalities. Improvement was described by all studies in symptoms, clinical outcomes, and/or immune parameters after LTA treatment, with greater improvements in a subset of symptoms beyond that observed with INCSs. Concomitant asthma, aspirin-exacerbated respiratory disease, and atopy di…
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There is insufficient evidence to recommend antileukotrienes for treating NO in chronic rhinosinusitis with nasal polyps.
“There is insufficient evidence to recommend the use of antileukotrienes for treating NO in CRS with NP [154].”
From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [154]
Cites
Fokkens, W. J., Lund, V. J., Mullol, J., Bachert, C., Alobid, I., Baroody, F., Cohen, N., Cervin, A., Douglas, R., Gevaert, P., et al. (2012) · Rhinology journal · doi:10.4193/rhino12.000 · Cited by 2,387 · see citing works
Self-citationData Extraction Errors in Meta-analyses That Use Standardized Mean Differences
Gøtzsche, P. C., Hróbjartsson, A., Marić, K., & Tendal, B. (2007) · JAMA · doi:10.1001/jama.298.4.430 · Cited by 238 · see citing works
Chambers, D., Rodgers, M., & Woolacott, N. (2009) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2008.12.010 · Cited by 121 · see citing works
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International Consensus Statement on Allergy and Rhinology: Rhinosinusitis
Orlandi, R. R., Kingdom, T. T., Hwang, P. H., Smith, T. L., Alt, J. A., Baroody, F. M., Batra, P. S., Bernal‐Sprekelsen, M., Bhattacharyya, N., Chandra, R. K., et al. (2016) · International Forum of Allergy & Rhinology · doi:10.1002/alr.21695 · Cited by 892 · see citing works
Self-citationPosition Paper on Nasal Obstruction: Evaluation and Treatment
SEAIC Rhinoconjunctivitis Committee & SEORL Rhinology, A., Valero, A., Navarro, A., del Cuvillo, A., Alobid, I., Benito, Jr., Colás, C., de los Santos, G., Fernández Liesa, R., García-Lliberós, A., et al. (2018) · Journal of Investigational Allergology and Clinical Immunology · doi:10.18176/jiaci.0232 · Cited by 76 · see citing works
- Authors
- Wentzel, J. L., Soler, Z. M., DeYoung, K., Nguyen, S. A., Lohia, S., & Schlosser, R. J.
- Affiliations
- Medical University of South Carolina (US)
- Corresponding author
- Wentzel, Jennifer L.
- Venue
- American Journal of Rhinology & Allergy
- Publisher
- SAGE Publications
- Published
- 2013-11
- Volume
- 27
- Issue
- 6
- Pages
- 482-489
- ISSN
- 1945-8924 (ISSN-L)
- 1945-8932
- PMC
- PMC3899527
- OpenAlex
- W2028348104
- Cited by
- 79
- References
- 3
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 2 · 2023: 7 · 2022: 6 · 2021: 2 · 2020: 6 · 2019: 5 · 2018: 6 · 2017: 7 · 2016: 12 · 2015: 12 · 2014: 5 · 2013: 1
- FWCI
- 2.12
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- American Journal of Rhinology and Allergy (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Otorhinolaryngology › Sinusitis and nasal conditions
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cystic Fibrosis Research Advances
- Keywords
- leukotriene antagonists, nasal polyps, chronic rhinosinusitis with nasal polyps, intranasal corticosteroids, adjunctive therapy, nasal symptoms, immunological parameters, aspirin-exacerbated respiratory disease, atopy, asthma
- MeSH terms
- Adrenal Cortex Hormones, Chronic Disease, Humans, Nasal Polyps, Recurrence, Rhinitis, Sinusitis, Randomized Controlled Trials as Topic, Leukotriene Antagonists
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