Montelukast Sodium Combination Therapy Significantly Improves Outcomes in Pediatric Cough Variant Asthma

A recent meta-analysis has demonstrated the clinical efficacy of montelukast sodium combination therapy for children with cough variant asthma (CVA). This study reviewed 18 clinical trials from Chinese populations, comparing combination therapy (montelukast sodium plus standard treatments) to control treatments, which included budesonide, fluticasone propionate, salmeterol-fluticasone, or ketotifen alone.
The analysis revealed that the combination therapy group had a significantly higher effective treatment rate (relative ratio [RR]: 1.23, 95% confidence interval [CI]: 1.18-1.29, p < 0.001) than the control group, with no significant difference in adverse reactions between groups (RR: 0.65, 95% CI: 0.42-1.02, p = 0.060). 
Pulmonary function parameters, including peak expiratory flow (PEF), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC ratios, were significantly improved in the combination therapy group compared to controls (p < 0.001).
Moreover, the combined therapy resulted in significantly lower levels of inflammatory markers, including tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4), and IgE, indicating better control of airway inflammation (p < 0.001).
This meta-analysis highlights that montelukast sodium, when used alongside standard asthma treatments, provides superior clinical outcomes in managing pediatric CVA. These findings support the use of combination therapy as a practical approach to improving both respiratory function and inflammation control in children with CVA.