Montelukast was superior to placebo, inferior to desloratadine and cetirizine, and enhanced the effect of nonsedating antihistamines when combined with them (SOR: B, systematic review of heterogenous randomized controlled trials [RCTs]). For patients who have failed cetirizine alone, adding montelukast has greater therapeutic effect than adding ranitidine (SOR: B, small RCT).