Leukotriene Receptor Antagonists for the Treatment of Atopic Dermatitis: A Systematic Review and Meta-analysis

Atopic dermatitis is a chronic skin condition with no cure. Current conventional treatments can have many side effects or are expensive. Emerging evidence suggests leukotriene receptor antagonists could serve as a corticosteroid-sparing option. This meta-analysis examined 26 studies on the efficacy of leukotriene receptor antagonists for treating atopic dermatitis across 742 participants. There were non-significant reductions in atopic dermatitis severity overall. However, in subgroup analyses montelukast significantly reduced Severity Scoring of Atopic Dermatitis scores in adult populations (SMD = -0.94, 95% CI -1.35 to -0.54, p < 0.0001) and also when compared with conventional treatment rather than placebo (SMD = -0.84, 95% CI -1.21 to -0.47, p < 0.0001). Studies excluded from the statistical analysis generally showed a positive trend favouring montelukast, even if results were not statistically significant. Montelukast shows potential as an adjunct therapy in atopic dermatitis, particularly in adults, but its efficacy is inconsistent. While it may help with pruritus, it should not replace standard treatments. Future research should focus on standardized assessments and personalized approaches to clarify its role in atopic dermatitis management.