A significant proportion of patients with
chronic urticaria respond inadequately to first line treatment with
antihistamines. Leukotreine receptor antagonists (LTRA) are also used for
chronic urticaria, although firm recommendations on their use are lacking. We performed a systematic review of randomised trials to determine the role of LTRA in treatment of
chronic urticaria. A search of PUBMED, EMBASE, SCOPUS, LILACS, the Cochrane Central Register of Controlled Trials, and the Web of Science for relevant randomized control trials or cross over studies yielded 10 eligible studies. The heterogeneity of trials were high, preventing valid meta-analysis of data. Most trials indicated that LTRA are not superior to placebo or
antihistamine therapy, while combination
therapy of LTRA and
antihistamines appear to be more efficacious compared to
antihistamine alone. The side effect profile and tolerability of this group of drugs is acceptable. The use of LTRA as monotherapy cannot be recommended. LTRA are effective add-on
therapy to anti-histamines, and their use in patients responding poorly to
antihistamines is justifiable. Further well designed randomized controlled trials with clear and standardized outcome measures are needed to determine the role of LTRA in
chronic urticaria.