CRD summary: This review aimed to compare the efficacy of montelokast with current therapies for seasonal allergic rhinitis. The authors concluded that there was no evidence to support the use of montelokast (alone or in combination with antihistamines) over intranasal corticosteroids. Limitations in the review methods and the reporting of included studies mean that these conclusions should be viewed with caution.

CRD commentary: The review question was clearly stated. However, the authors did not specify any inclusion criteria for the outcome measures, beyond the statement that they aimed to assess efficacy, safety and tolerability. The search was limited to two electronic databases and only literature published in English was included. Hence, it is possible that relevant studies were missed and that language and/or publication bias might have been present. No details of the review process were reported, thus it was not possible to assess whether steps were taken to reduce errors and/or reviewer bias. The results of the included studies were tabulated and discussed in a narrative in which studies were grouped by comparator (placebo or active control). The narrative lacked an overall summary and focused on reporting the individual study results. Some potentially important study details were not presented, e.g. the number of participants in each treatment arm and baseline characteristics. Given these limitations, the conclusions of the review should be interpreted with caution.