Newer-generation antihistamines and the risk of adverse events in children: a systematic review

Miligkos, Michael; Dakoutrou, Maria; Statha, Eleni; Theochari, Nikoletta A; Mavroeidi, Ilektra Antonia; Pankozidou, Ιoanna; Papaconstadopoulos, Irene; Papadopoulos, Nikolaos G.

doi:10.22541/au.160680607.70423821/v1

Cited by 1 publication

(1 citation statement)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As a relatively higher and more favorable affinity and selectivity for the H 1 receptor antagonist, CTZ confers a more potent, faster onset, and longer duration of action (41). However, clinical investigations and spontaneous data analyses indicate that CTZ is also associated with an increased risk of drug-related CNS reactions (7,8), such as somnolence, which was previously indicated by a safety evaluation of newer-generation AHs (42). In addition, the danger of AEs involving growth impairment or cognitive development is particularly important.…”

Section: Evidence Summary and Updatementioning

confidence: 99%

Cetirizine for the treatment of allergic diseases in children: A systematic review and meta-analysis

et al. 2022

View full text Add to dashboard Cite

ObjectiveThe global prevalence of allergic diseases has led to a negative and extensive impact on the health and lives of a large population of children. This study investigates the efficacy, acceptability, and safety of cetirizine (CTZ) for treating allergic diseases in children and provides evidence-based assertions for decision-making.MethodsPubMed, Embase, the Cochrane Library, World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov, and the European Union Clinical Trials Register were systematically searched from inception to April 21, 2022. Randomized controlled trials (RCTs) or quasi-RCTs of children with allergic diseases receiving CTZ compared with those receiving placebo or other drugs were included without language limitations. Two investigators independently identified articles, extracted data, conducted meta-analyses, assessed the Cochrane risk of bias of individual studies, and evaluated the evidence certainty using the Grading of Recommendations Assessment, Development, and Evaluation approach; any discrepancies were resolved by consulting with a third investigator. Primary outcomes included scales that evaluated the recovery of allergic conditions in AR, such as the total symptom score (TSS). Secondary outcomes included laboratory test changes, safety (adverse events, AEs), and quality of life (QOL). Data were pooled using the Cochrane Review Manager 5.4, and a fixed-effects model was used if heterogeneity was evaluated as low (I2 < 50%); otherwise, a random-effects model was adopted.ResultsA total of 22 studies (5,867 patients) were ultimately included [eight with perennial AR, six with seasonal AR, four with atopic dermatitis (AD), and four with other allergic diseases], most of which had a low or unclear risk of bias. Moderate certainty evidence showed that CTZ was found to benefit allergic symptom control [mean difference (MD) of TSS at 1 week: MD, –0.32 (–0.52, –0.12); at 2 weeks: MD, –0.25 (–0.35, –0.14); at 4 weeks: MD, –4.07 (–4.71, –3.43); at 8 weeks: MD, –4.22 (–4.73, –3.72); at 12 weeks: MD, –5.63 (–6.14, –5.13); all P-values were less than 0.05] and QOL [at 12 weeks: MD, –23.16 (–26.92, –19.39); P < 0.00001] in children with AR. It had similar efficacy compared with other antihistamines (AHs) or montelukast, without showing better control of AD severity in children. Moderate-to-low certainty evidence demonstrated that CTZ was well tolerated and did not increase the risk of severe and overall AEs, cardiotoxicity, damage to the central nervous and digestive systems, or other systems in children, except for the risk of somnolence [risk ratio, 1.62 (1.02, 2.57); P = 0.04, compared with placebo].ConclusionModerate-to-low certainty evidence revealed that CTZ could improve clinical improvement and QOL in children with AR and have comparable efficacy with other AHs. CTZ is well tolerated in the pediatric population, except for an increased risk of somnolence.Systematic review registration[https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42021262767].

show abstract

Section: Evidence Summary and Updatementioning

confidence: 99%