In a meta-analysis published in "BMC Pulmonary Medicine",  combining Montelukast with Fluticasone enhanced treatment effectiveness for cough variant asthma (CVA) in children. Furthermore, it improved forced expiratory volume in 1 second (FEV1%), reduced recurrence rates, cough remission time, and cough disappearance time without a significant escalation in adverse reactions when compared to Fluticasone alone. The study aimed to assess the efficacy and safety of Montelukast + Fluticasone propionate vs Fluticasone propionate for pediatric CVA.

Relevant studies were retrieved from electronic databases, such as China National Knowledge Infrastructure (CNKI), PubMed, Embase, WanFang, and China Science and Technology Journal Database (CQVIP). The specific inclusion criteria for the selected studies were: (i) individuals under 18 years old diagnosed with variant asthma; (ii) research specifically addressing distinctions between Montelukast + Fluticasone propionate and Fluticasone propionate; (iii) studies designed as randomized controlled trials (RCTs); and (iv) studies incorporating one or more of the subsequent outcomes: time to cough remission, treatment effectiveness, score of cough symptoms, recurrence rate of cough, time to cough disappearance, percentage of predicted peak expiratory flow (PEF%), FEV%, and adverse reactions.

Categorical variables were examined through risk ratio (RR) and 95% confidence interval (CI) while continuous variables were investigated utilizing weighted mean difference (WMD) and 95% CI. Heterogeneity analysis was conducted using Cochran’s Q test and I2 statistics, followed by sensitivity analysis and evaluation of publication bias. Nine studies were incorporated, revealing a notable enhancement in the overall effectiveness and a decrease in cough recurrence with Fluticasone propionate + Montelukast compared to Fluticasone propionate.

The combination group exhibited significantly shorter times for cough remission and disappearance compared to the monotherapy group. Additionally, there was a noteworthy improvement in FEV1% recovery in the Montelukast + Fluticasone Propionate group compared to the Fluticasone propionate group. Therefore, Montelukast in combination with Fluticasone is a relatively efficacious and safe regimen for relieving CVA in children.