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Key points

• Allergic rhinitis is common.

• This systematic review outlines the evidence regarding montelukast in allergic rhinitis and provides a meta-analysis of its efficacy.

• The evidence suggests that montelukast does reduce nasal symptom score by 3.4% (95% CI: 2.5% to 4.2%) when compared with placebo.

• Montelukast is not as effective as topical nasal steroids or antihistamines and should therefore be regarded as second line therapy.

• When used, montelukast should be used in combination with an antihistamine.