Antihistaminines

Background
Eczema is a common skin disease in many countries, and although the majority of cases of eczema occur before the age of five years and often resolve during childhood or adolescence, it can also persist into adulthood. Itch is the most important aspect of eczema, often impacting significantly on the quality of life of an affected individual.
Objectives
To assess the effects of oral antihistamines (H1 antagonists) as monotherapy in children and adults with eczema.
Search methods
We searched the following databases up to March 2012: the Cochrane Skin Group Specialised Register, CENTRAL in The Cochrane
Library (2012, Issue 3),MEDLINE (from 1946), EMBASE (from 1974), and LILACS (from 1982).We examined the reference lists of
excluded studies in order to identify further references to relevant trials.We searched trials registers for ongoing and unpublished trials.
We also handsearched the abstracts of the International Research Workshops on eczema, as well as the conference proceedings of the
European Academy of Dermatology and Venereology (EADV) and the European Academy of Allergology and Clinical Immunology
(EAACI), from 2000 to 2011.
Selection criteria
We sought to include randomised controlled trials that assessed the effects and safety of oral H1 antihistamines as monotherapy in
children and adults with eczema.We excluded studies that compared an antihistamine versus another antihistamine and had no placebo
control arm. We also excluded topical antihistamines and oral H1 antihistamines as ’add-on’ therapy and studies using any concomitant therapy other than emollients or moisturisers, principally because some of these forms of concomitant therapy may be considered treatment modifiers in assessments of the effects of antihistamines on eczema.
Data collection and analysis
Our search retrieved 409 references to studies. Based on assessments of their titles, abstracts, or both, we excluded all except 36 of these studies. After evaluation of the full text of each report, we excluded a further 35 studies, and 1 study is awaiting classification pending a response from the trial investigators.
Main results
No randomised controlled trials met our inclusion criteria.
Authors’ conclusions
There is currently no high-level evidence to support or refute the efficacy or safety of oral H1 antihistamines used as monotherapy for eczema. Becausemost of the studies allowed the use of concomitant medications and involvedmulti-therapeutic approaches, meaningful assessments of the individual effects of oral H1 antihistamines on eczema were not feasible. Although well-designed randomised controlled trials excluding concomitant medications appear to be needed, consideration should be given to the potential ethical issues raised with the use of antihistamines as monotherapy for the management of eczema by withholding the use of rescue or additional therapies. A further systematic review of studies in which concomitant therapies were permitted might be of value in determining the potential benefits of oral H1 antihistamines as add-on therapy.

Allergic rhinitis represents global health problems for all age groups. The prevalence of allergic rhinitis in Poland has dramatically increased in the past two decades. Rhinitis symptoms; congestion, rhinorrhea, sneezing and nasal pruritis, can significantly affect the quality of life. Last years has seen the development of a number of guidelines and position papers on the treatment of allergic rhinitis. Nonquestionable advantage of intranasal glucocorticosteroids is their strong anti-inflammatory local action and little impact on general health. According to PoSLeNN and ARIA 2010 recommendations intranasal corticosteroids are considered the first line drugs for moderate and severity intermittent and all stages of persistent allergic rhinitis. Though in everyday practice it seems advantageous to use more than one group of medicines at the same time in order to treat allergic rhinitis comprehensively, especially in patients with severe symptoms or polymorphous allergy.

BACKGROUND: In early clinical trials, infusion reactions during the administration of taxanes were managed using systematic premedication with antihistamines and corticosteroids prior to standard infusions. Consequently, these premedications are also administered prior to rapid drug desensitization (RDD) with taxanes. However, their role in RDD has not been studied.
OBJECTIVE: To assess the need for premedication with antihistamines and corticosteroids to prevent hypersensitivity reactions in RDD to paclitaxel.
METHODS: Over a 4-year period, we selected patients with confirmed hypersensitivity to paclitaxel (positive skin testing and/or drug provocation testing results) who had received paclitaxel through RDD. These patients were assigned to 2 prospective non-inception cohorts: one cohort premedicated with antihistamine and corticosteroids and another cohort that was not.
RESULTS: We assessed 66 paclitaxel-reactive patients, of whom 22 met the inclusion criteria. There were no significant differences in tolerance to RDD between the cohorts.
CONCLUSIONS: Administering systematic premedication with corticosteroids and antihistamines had no significant effect on the effectiveness or safety of RDD in patients with confirmed hypersensitivity to paclitaxel in the study population. Moreover, these premedications can mask the early signs of hypersensitivity and delay treatment. We believe that systematic premedication with these drugs for patients undergoing RDD should be carefully and individually assessed if their only purpose is to prevent breakthrough reactions during RDD.

Background: Different studies demonstrate superiority of Cetirizine over Loratadine in the suppression of flare reactions caused by Epicutaneus Skin Prick Test with Histamine (ESPTH) but there are contradictory evidences regarding their effect on the weal reactions. This study aimed to compare these superiorities. Method: Loratadine 10 mg and Cetirizine 10 mg were given to 26 volunteers in a double-blind, randomized cross-over method. The subjects performed the ESPTH immediately before the medications were administered, and then 30 minutes, 1, 3, 5, 6 and 24 hours after they received the drugs. Twenty minutes after each ESPTH, flare and weal were drawn into a transparent paper. After four weeks the subgroups changed the drugs and underwent the same procedure. To analyze the differences between flare and weal, we carefully cut the transparent paper tracings and weighed them in an analytical weighing-machine. The differences were analyzed with Wilcoxon Signed Ranks Test. Results: Cetirizine ...