A simulated car‐driving study on the effects of acute administration of levocetirizine, fexofenadine, and diphenhydramine in healthy Japanese volunteers
“…Finally, 51 RCTs satisfied the inclusion criteria and then were included in our meta-analysis [9–59]. Notably, partial data from 8 RCTs [15, 24, 28, 30, 36, 53, 56, 58] were only reported in graphics and; the attempt to obtain data directly from the authors failed, so graphics were digitized and the SD were estimated using an imputation method. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Forty-one studies reported AE after taking fexofenadine [9–11, 13–26, 28–30, 32–36, 39–54]. Of 41 studies, 10 compared with the first-generation antihistamines [15, 19, 24, 28–30, 43, 49, 50, 53], 22 compared with the second-generation antihistamines [9, 14, 16–18, 20–23, 25, 28, 33, 35, 36, 40, 44, 47–49, 52–54], and 37 compared with placebo [9–11, 13–17, 19–25, 28–30, 32–34, 36, 39–49, 51–54]. When compared with the first-generation antihistamines, as demonstrated in Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Seven studies reported the LARS of subjects after taking fexofenadine [15, 24, 28, 30, 49, 53, 58]. Of the 7 studies on healthy subjects, 3 compared with the second-generation antihistamines [15, 28, 49], all compared with the first-generation antihistamines and placebo [15, 24, 28, 30, 49, 53, 58]. As shown in Fig.…”
BackgroundAs a new generation antihistamine, fexofenadine has been widely used in allergic diseases. However, there is still a lack of collective evidence regarding the antihistamine effects and safety profiles of fexofenadine relative to other antihistamine drugs and placebo. Therefore, we aimed to systematically evaluate the antihistamine effects and safety of fexofenadine.MethodsAn electronic literature search of randomized controlled trials (RCTs) was performed using Embase, Cochrane and PubMed from establishment to January 1st, 2018. RCTs comparing the antihistamine effects or safety (adverse events, sedative effects, and cognitive/psychomotor function) of fexofenadine with either other antihistamines or placebo for healthy subjects and patients with allergy were selected.ResultsFifty-one studies of 14,551 participants met the inclusion criteria. When compared with the first-generation antihistamines, fexofenadine produced significantly lower adverse events frequency (OR = 0.446; 95% CI: 0.214 to 0.929, P = 0.031), significantly lower sedative effects frequency (OR = 0.265; 95% CI: 0.072 to 0.976, P = 0.046) and significantly less change of all cognitive/psychomotor function. When compared with the second-generation antihistamines, fexofenadine produced significantly marginal sedative effects (OR = 0.59; 95% CI, 0.38 to 0.93; P = 0.02) and significantly less change of most of the cognitive/psychomotor function. When compared with placebo, fexofenadine produced more significant antihistamine effects.ConclusionsFexofenadine has a positive antihistamine effect, which is probably no worse than the second-generation antihistamines. Fexofenadine probably has a favorable safety profile, which is more likely better than that of the first-generation antihistamines. There is lack of data to support that fexofenadine has a better overall safety profile compared to the second-generation antihistamines, however, some presently available evidence on sedative effects and certain aspects of cognitive/psychomotor function favors fexofenadine. Therefore, fexofenadine may be worthy of recommendation for safety related workers.
“…Finally, 51 RCTs satisfied the inclusion criteria and then were included in our meta-analysis [9–59]. Notably, partial data from 8 RCTs [15, 24, 28, 30, 36, 53, 56, 58] were only reported in graphics and; the attempt to obtain data directly from the authors failed, so graphics were digitized and the SD were estimated using an imputation method. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Forty-one studies reported AE after taking fexofenadine [9–11, 13–26, 28–30, 32–36, 39–54]. Of 41 studies, 10 compared with the first-generation antihistamines [15, 19, 24, 28–30, 43, 49, 50, 53], 22 compared with the second-generation antihistamines [9, 14, 16–18, 20–23, 25, 28, 33, 35, 36, 40, 44, 47–49, 52–54], and 37 compared with placebo [9–11, 13–17, 19–25, 28–30, 32–34, 36, 39–49, 51–54]. When compared with the first-generation antihistamines, as demonstrated in Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Seven studies reported the LARS of subjects after taking fexofenadine [15, 24, 28, 30, 49, 53, 58]. Of the 7 studies on healthy subjects, 3 compared with the second-generation antihistamines [15, 28, 49], all compared with the first-generation antihistamines and placebo [15, 24, 28, 30, 49, 53, 58]. As shown in Fig.…”
BackgroundAs a new generation antihistamine, fexofenadine has been widely used in allergic diseases. However, there is still a lack of collective evidence regarding the antihistamine effects and safety profiles of fexofenadine relative to other antihistamine drugs and placebo. Therefore, we aimed to systematically evaluate the antihistamine effects and safety of fexofenadine.MethodsAn electronic literature search of randomized controlled trials (RCTs) was performed using Embase, Cochrane and PubMed from establishment to January 1st, 2018. RCTs comparing the antihistamine effects or safety (adverse events, sedative effects, and cognitive/psychomotor function) of fexofenadine with either other antihistamines or placebo for healthy subjects and patients with allergy were selected.ResultsFifty-one studies of 14,551 participants met the inclusion criteria. When compared with the first-generation antihistamines, fexofenadine produced significantly lower adverse events frequency (OR = 0.446; 95% CI: 0.214 to 0.929, P = 0.031), significantly lower sedative effects frequency (OR = 0.265; 95% CI: 0.072 to 0.976, P = 0.046) and significantly less change of all cognitive/psychomotor function. When compared with the second-generation antihistamines, fexofenadine produced significantly marginal sedative effects (OR = 0.59; 95% CI, 0.38 to 0.93; P = 0.02) and significantly less change of most of the cognitive/psychomotor function. When compared with placebo, fexofenadine produced more significant antihistamine effects.ConclusionsFexofenadine has a positive antihistamine effect, which is probably no worse than the second-generation antihistamines. Fexofenadine probably has a favorable safety profile, which is more likely better than that of the first-generation antihistamines. There is lack of data to support that fexofenadine has a better overall safety profile compared to the second-generation antihistamines, however, some presently available evidence on sedative effects and certain aspects of cognitive/psychomotor function favors fexofenadine. Therefore, fexofenadine may be worthy of recommendation for safety related workers.
“…In many day-to-day situations consistently fast reaction times are important, such as in driving a vehicle on a busy road. (Inami et al, 2016;Salvia et al, 2016, Desapriya et al, 2014Sun, Xia, Falkmer, & Lee, 2016). Various professions place strong focus on fast response times, and therefore reaction time testing is a key component in assessments for pilots (Truszczynski, Lewkowicz, Wojtkowiak, & Biernacki, 2014) and cosmonauts (Bock, Weigelt, & Bloomberg, 2010).…”
Reaction times are often used as an indicator of the efficiency of the processes in thecentral nervous system. While extensive research has been conducted on the possibleresponse time correlates, the role of eye movements in visual tasks is yet unclear. Here wereport data to support the role of eye movements during visual choice reaction time training.Participant performance, reaction times, and total session duration improved. Eyemovementsshowed expected changes in saccade amplitude and resulted in improvementin visual target searching.
“…In addition, levocetirizine 5 mg does not affect cognitive functions and car-driving performance . Our recent study also showed that levocetirizine did not impair car-driving performance in young Japanese adults (Inami et al, 2016). A brain histamine H 1 R occupancy (H 1 RO) measure has been added as an objective measure to the Consensus Group on New-Generation Antihistamines (CONGA) (Holgate et al, 2003).…”
ObjectiveAntihistamines often have sedative side effects. This was the first study to measure regional cerebral glucose (energy) consumption and hemodynamic responses in young adults during cognitive tests after antihistamine administration.MethodsIn this double‐blind, placebo‐controlled, three‐way crossover study, 18 healthy young Japanese men received single doses of levocetirizine 5 mg and diphenhydramine 50 mg at intervals of at least six days. Subjective feeling, task performances, and brain activity were evaluated during three cognitive tests (word fluency, two‐back, and Stroop). Regional cerebral glucose consumption changes were measured using positron emission tomography with [18F]fluorodeoxyglucose. Regional hemodynamic responses were measured using near‐infrared spectroscopy.ResultsEnergy consumption in prefrontal regions was significantly increased after antihistamine administration, especially diphenhydramine, whereas prefrontal hemodynamic responses, evaluated with oxygenated hemoglobin levels, were significantly lower with diphenhydramine treatment. Stroop test accuracy was significantly impaired by diphenhydramine, but not by levocetirizine. There was no significant difference in subjective sleepiness.ConclusionsPhysiological “coupling” between metabolism and perfusion in the healthy human brain may not be maintained under pharmacological influence due to antihistamines. This uncoupling may be caused by a combination of increased energy demands in the prefrontal regions and suppression of vascular permeability in brain capillaries after antihistamine treatment. Further research is needed to validate this hypothesis.
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