The Role of Cetirizine in the Changing Landscape of IV Antihistamines: A Narrative Review

Blaiss, Michael S.; Bernstein, Jonathan A.; Kessler, Adam; Pines, Jesse M.; Camargo, Carlos A.; Fulgham, Paula; Haumschild, Ryan J.; Rupp, Kristin; Tyler, Timothy; Moellman, Joseph J.

doi:10.1007/s12325-021-01999-x

Cited by 8 publications

(10 citation statements)

References 44 publications

(55 reference statements)

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“…Cetirizine is a second-generation histamine H1 receptor antagonist with fewer side effects, such as sedation and drowsiness, than promethazine ( 13 ). Cetirizine can reduce allergic reactions and systemic capillary leakage and is clinically applied for treating urticaria, allergic rhinitis, dermatitis, and conjunctivitis ( 14 ). In addition, cetirizine is an unconventional drug for treating post-burn pruritus ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

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Histamine H1 receptor antagonist attenuates catecholamine surge and organ injury after severe burns

Wang

Liu

et al. 2023

Front. Endocrinol.

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Severe burns induce a catecholamine surge, causing severe damage to the organism and raising the possibility of multisystem organ failure. Few strategies are generally acceptable to reduce catecholamine surge and organ injury post-burn. We have previously shown that histamine can amplify the catecholamine surge. In addition, promethazine, a first-generation histamine H1 receptor antagonist, alleviates catecholamine surge and organ injury after severe burns in rats. However, evidence is lacking on whether promethazine benefits patients after severe burns. Currently, sedation and analgesia (such as midazolam and fentanyl) are commonly required for patients after severe burns. It remains unclear if patients after severe burns derive clinical benefit from histamine H1 receptor antagonists combined with sedation and analgesia. This study investigates the therapeutic effect of promethazine on patients after severe burns. Moreover, we test the therapeutic effect of cetirizine, a second-generation histamine H1 receptor antagonist, combined with sedation and analgesia in rats after severe burns. We find that promethazine-pethidine treatment shows a tendency for a lower level of total bilirubin than midazolam-fentanyl in patients 7-day after severe burn. Our study confirms that cetirizine combined with midazolam and fentanyl reduces catecholamine surge and liver and lung damage after severe burns in rats; the effects are better than midazolam and fentanyl treatment. In summary, for the first time, we suggest that histamine H1 receptor antagonist has the potential clinical value of reducing liver injury in patients after severe burns. In addition, we reveal that cetirizine combined with midazolam and fentanyl may be an ideal strategy for treating severe burns.

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Section: Discussionmentioning

confidence: 99%

“…Cetirizine is a second-generation histamine H1 receptor antagonist commonly used in clinical practice. Compared with promethazine, cetirizine has fewer side effects such as sedation and drowsiness ( 13 , 14 ). Thus, cetirizine may be an ideal alternative to promethazine.…”

Section: Introductionmentioning

confidence: 99%

Histamine H1 receptor antagonist attenuates catecholamine surge and organ injury after severe burns

Wang

Liu

et al. 2023

Front. Endocrinol.

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“…Third, further studies should focus on intravenously administered CTZ, which has already been approved to treat acute urticaria in children as young as 6 months of age. A narrative review reported that intravenous CTZ was non-inferior to intravenous diphenhydramine in terms of a 2-h pruritus score and was associated with fewer AEs ( 55 ). Finally, besides its relevant anti-allergic activity, studies have revealed that CTZ might have potential anti-inflammatory properties with known or unknown mechanisms, which might be new therapeutic targets for multiple pediatric allergic conditions ( 56 , 57 ).…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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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].

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“… 12 CTZ acts on these allergies by selectively inhibiting peripheral H1 receptors. 13 However, after drug withdrawal, the allergy is easy to recur, which will induce itching again. 14 Another drug, bifid triple viable capsules, is composed of Bifidobacterium, Lactobacillus and Enterococcus , which has been shown to be effective against diarrhea caused by GMB disturbances or enteritis and has been approved by the State Food and Drug Administration of China as a nonprescription drug.…”

Section: Introductionmentioning

confidence: 99%

Influences of Bifid Triple Viable Capsules Plus Cetirizine on Gut Microbiota and Immune Function in Children with Eczema

Zhen-xing¹,

Kang²

2022

DDDT

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Objective Infantile eczema (IE), a common pediatric allergic skin disease caused by multiple inherent and external factors, is common in infants and young children, with skin lesions and itching as the main clinical manifestations. At present, its pathological mechanism has not been thoroughly clarified, but scholars believe that it is related to the joint action of various internal and external factors. This research aims to investigate the influences of bifid triple viable capsules plus cetirizine (CTZ) on gut microbiota (GMB) and immunity in children with eczema. Methods The complete clinical data of 162 cases of IE presented between July 2019 and July 2020 to the First Hospital of Shanxi Medical University were retrospectively analyzed. Children treated by CTZ alone were assigned to the control group (n = 81) and those by CTZ plus bifid triple viable capsules were included in the observation group (n = 81). Therapeutic efficacy, adverse reactions (ARs), disease recurrence, as well as changes in GMB, inflammatory factors (IFs) and immunoglobulins (Igs) were observed. Results The observation group was observed with a higher overall response rate and increased fecal Lactobacillus, Escherichia coli ( E. coli ) and Bifidobacterium counts after treatment versus the control group. After treatment, reduced IgG and IgM, as well as IFs, were found in both groups, with lower levels in the observation group. A lower incidence of ARs was determined in the observation group. Conclusion With high efficacy for the treatment of IE, bifid triple viable capsules plus CTZ can validly regulate the GMB of children, improve their immune function and clinical symptoms, and reduce the disease recurrence rate, which is worthy of clinical promotion.

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The Role of Cetirizine in the Changing Landscape of IV Antihistamines: A Narrative Review

Cited by 8 publications

References 44 publications

Histamine H1 receptor antagonist attenuates catecholamine surge and organ injury after severe burns

Histamine H1 receptor antagonist attenuates catecholamine surge and organ injury after severe burns

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

Influences of Bifid Triple Viable Capsules Plus Cetirizine on Gut Microbiota and Immune Function in Children with Eczema

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