H1-antihistamines for chronic spontaneous urticaria: an abridged Cochrane Systematic Review.

Abstract

BACKGROUND:

Chronic spontaneous urticaria is characterized by recurrent itchy wheals. First-line management is with H1-antihistamines.

OBJECTIVE:

We sought to conduct a Cochrane Review of H1-antihistamines in the treatment of chronic spontaneous urticaria.

METHODS:

A systematic search of major databases for randomized controlled trials was conducted.

RESULTS:

We included 73 studies with 9759 participants; 34 studies provided outcome data for 23 comparisons. Compared with placebo, cetirizine 10 mg daily in the short and intermediate term (RR 2.72; 95% confidence interval [CI] 1.51-4.91) led to complete suppression of urticaria. Levocetirizine 20 mg daily was effective for short-term use (RR 20.87; 95% CI 1.37-317.60) as was 5 mg for intermediate-term use (RR 52.88; 95% CI 3.31-843.81). Desloratadine 20 mg was effective for the short term (RR 15.97; 95% CI 1.04-245.04) as was 5 mg in the intermediate term (RR 37.00; 95% CI 2.31-593.70). There was no evidence to suggest difference in adverse event rates between treatments.

LIMITATIONS:

Some methodological limitations were observed. Few studies for each comparison reported outcome data that could be incorporated in meta-analyses.

CONCLUSIONS:

At standard doses, several antihistamines are effective and safe in complete suppression of chronic spontaneous urticaria. Research on long-term treatment using standardized outcome measures and quality of life scores is needed.

• Authors: Maulina Sharma, Cathy Bennett, Ben Carter, Stuart N Cohen
• Journal: Journal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 73 Issue 4 Pg. 710-716.e4 (Oct 2015) ISSN: 1097-6787 [Electronic] United States
• PMID: 26253363 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review, Systematic Review)
• Copyright: Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Chemical References

• Histamine Antagonists

Topics

• Chronic Disease
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Female
• Follow-Up Studies
• Histamine Antagonists (therapeutic use)
• Humans
• Male
• Quality of Life
• Randomized Controlled Trials as Topic
• Recurrence
• Severity of Illness Index
• Treatment Outcome
• Urticaria (diagnosis, drug therapy, psychology)