Oral H1 antihistamines as ‘add-on’ therapy to topical treatment for eczema

Matterne, Uwe; Böhmer, Merle M.; Weißhaar, Elke; Jupiter, Aldrin; Carter, Ben; Apfelbacher, Christian

doi:10.1002/14651858.cd012167.pub2

Cited by 52 publications

(60 citation statements)

References 119 publications

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“…Nocturnal pruritus is a common problem in medium‐to‐severe AD. A recent Cochrane Review concluded that there is no consistent evidence for the effectiveness of oral H1 antihistamines 133 . Sedating H1 antihistamines may be tried for a short period in acute exacerbations, when sleep disturbances persist despite TCS and emollient use, 270 but long‐term use is not recommended.…”

Section: Specific Considerations For Childrenmentioning

confidence: 99%

ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children

Wollenberg

Christen-Zäch

Taı̈eb

et al. 2020

Acad Dermatol Venereol

279

360

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Atopic dermatitis (AD) is a highly pruritic, chronic inflammatory skin disease. The diagnosis is made using evaluated clinical criteria. Disease activity and burden are best measured with a composite score, assessing both objective and subjective symptoms, such as SCORing Atopic Dermatitis (SCORAD). AD management must take into account clinical and pathogenic variabilities, the patient's age and also target flare prevention. Basic therapy includes hydrating and barrierstabilizing topical treatment universally applied, as well as avoiding specific and unspecific provocation factors. Visible skin lesions are treated with anti-inflammatory topical agents such as corticosteroids and calcineurin inhibitors (tacrolimus and pimecrolimus), which are preferred in sensitive locations. Topical tacrolimus and some mid-potency corticosteroids are proven agents for proactive therapy, which is defined as the long-term intermittent anti-inflammatory therapy of frequently relapsing skin areas. Systemic anti-inflammatory or immunosuppressive treatment is a rapidly changing † See Appendix section.

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Section: Specific Considerations For Childrenmentioning

confidence: 99%

ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children

Wollenberg

Christen-Zäch

Taı̈eb

et al. 2020

Acad Dermatol Venereol

279

360

View full text Add to dashboard Cite

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“…Histamine is the essential pruritogen of urticaria and immediate-type allergic response, for which the first-line treatment is H1 receptor antagonists [ 55 , 56 , 57 ]. However, the anti-pruritic efficacy of H1 antagonists is quite limited in AD [ 58 ].…”

Section: Role Of Il-31 and Il-13/il-4 In Atopic Pruritusmentioning

confidence: 99%

Regulation of Skin Barrier Function via Competition between AHR Axis versus IL-13/IL-4‒JAK‒STAT6/STAT3 Axis: Pathogenic and Therapeutic Implications in Atopic Dermatitis

Furue

2020

JCM

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Atopic dermatitis (AD) is characterized by skin inflammation, barrier dysfunction, and chronic pruritus. As the anti-interleukin-4 (IL-4) receptor α antibody dupilumab improves all three cardinal features of AD, the type 2 cytokines IL-4 and especially IL-13 have been indicated to have pathogenic significance in AD. Accumulating evidence has shown that the skin barrier function is regulated via competition between the aryl hydrocarbon receptor (AHR) axis (up-regulation of barrier) and the IL-13/IL-4‒JAK‒STAT6/STAT3 axis (down-regulation of barrier). This latter axis also induces oxidative stress, which exacerbates inflammation. Conventional and recently developed agents for treating AD such as steroid, calcineurin inhibitors, cyclosporine, dupilumab, and JAK inhibitors inhibit the IL-13/IL-4‒JAK‒STAT6/STAT3 axis, while older remedies such as coal tar and glyteer are antioxidative AHR agonists. In this article, I summarize the pathogenic and therapeutic implications of the IL-13/IL-4‒JAK‒STAT6/STAT3 axis and the AHR axis in AD.

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“…In Japan, many study reports have discussed the positive effects of antihistamines on AD [39,59,60]. Conversely, in Europe and the United States, many reports have presented negative opinions [39,41,42,61,62]. Therefore, oral antihistamines are generally recommended as an adjuvant therapy to topical treatment with anti-inflammatory drugs and moisturizers [39] or as short-term sporadic use in patients with night-time itch [41,42].…”

Section: Oral Antihistamines/anti-allergic Drugsmentioning

confidence: 99%

Atopic Dermatitis in Older Adults: A Review of Treatment Options

Tanei

2020

Drugs Aging

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Atopic dermatitis (AD) in older adults (elderly AD) has recently emerged as a newly defined subgroup of AD. When selecting treatment options, clinical characteristics of elderly AD and age-specific factors of older patients must be considered. As in other age groups, regular application of moisturizers in combination with topical corticosteroids and calcineurin inhibitors, adjunctive administration of oral antihistamines/anti-allergic drugs, and avoidance of exacerbating factors comprise basic treatments for elderly AD. For moderate-to-severe cases and/or in those with a decreased ability to use topical treatments, powerful anti-inflammatory treatments may become necessary as additional treatment options. While low-dose oral corticosteroids may be useful for cases of elderly AD, careful attention should be paid to adverse effects. Oral cyclosporine (ciclosporin) is less commonly used due to the increased risk of malignancy and organ toxicity in older patients with AD.

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Oral H1 antihistamines as ‘add-on’ therapy to topical treatment for eczema

Abstract: Oral H1 antihistamines as 'add-on' therapy to topical treatment for eczema.

Cited by 52 publications

References 119 publications

ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children

ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children

Regulation of Skin Barrier Function via Competition between AHR Axis versus IL-13/IL-4‒JAK‒STAT6/STAT3 Axis: Pathogenic and Therapeutic Implications in Atopic Dermatitis

Atopic Dermatitis in Older Adults: A Review of Treatment Options

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