Evidence-based use of antihistamines for treatment of allergic conditions

Ann Allergy Asthma Immunol. 2023 Jul 28:S1081-1206(23)00524-0. doi: 10.1016/j.anai.2023.07.019. Online ahead of print.ABSTRACTAvailable since the 1940s, H1-antihistamines are mainstay treatments for allergic conditions such as allergic rhinitis and urticaria. They function as inverse agonists that bind to the H1 receptor to inhibit histamine-induced inflammation. The older, first-generation drugs are no longer recommended for patient use due to their well documented negative side effect profile. Evidence has been accumulating to support a newer generation of H1-antihistamines in oral and intranasal formulations, including in combination with intranasal corticosteroids. The literature is replete with large meta-analyses and systematic reviews establishing the safety and efficacy of second-generation H1-antihistamines in adult and pediatric allergic rhinitis populations including combination nasal spray agents (ex, MP29-02 or MP-AzeFlu). While intra-class differences do exist, patient preference, access and costs should the priority. Robust data on the regular, not as needed use, of H1-antihistamines for urticaria has been published including in the management of children and pregnant or lactating women. Additionally, H1-antihistamines can also be used in other related allergic conditions such as the secondary symptoms of anaphylaxis to provide patients with greater comfort, as well as in allergic asthma depending on the individual.PMID:37517656 | DOI:10.1016/j.anai.2023.07.019
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Source Type: research