An assessment of the use of antihistamines in the management of atopic dermatitis - 18/06/18
, Alan B. Fleischer, MD dAbstract |
Background |
Antihistamines are often used to treat pruritus associated with atopic dermatitis (AD) despite lack of evidence for their efficacy. The American Academy of Dermatology does not recommend the general use of antihistamines in the management of AD, although the value of short-term sedating antihistamine use for insomnia secondary to itch is recognized.
Objective |
To assess the use of sedating and nonsedating antihistamines for AD in 2003-2012.
Methods |
The National Ambulatory Medical Care Survey provided data on physician visits in 2003-2012. Sedating and nonsedating antihistamine use was identified at visits for AD.
Results |
There were 990,000 annual visits for AD. Antihistamines were prescribed for AD in a significant proportion of visits across physician specialties (16%-44%). Dermatologists and pediatricians primarily used sedating antihistamines (58%-70%), whereas the majority of family/general practitioners, internists, and other specialists prescribed nonsedating antihistamines for AD (55%-100%)
Limitations |
We were limited by the accuracy of AD diagnosis and medication recording.
Conclusions |
Antihistamines are widely used for the treatment of AD. There is no high-level evidence to suggest that nonsedating antihistamines reduce itch in patients with AD or that sedating antihistamines provide benefit in controlling AD symptoms (except perhaps sleep and AD comorbidities, such as allergic rhinitis).
Le texte complet de cet article est disponible en PDF.Key words : antihistamines, atopic dermatitis, guidelines, itch, treatments, trends
Abbreviations used : AAD, AD, NAMCS
Plan
| Funding sources: Supported by a grant from Regeneron. |
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| Disclosure: The Center for Dermatology Research is supported by an unrestricted educational grant from Galderma Laboratories, LP. Dr Feldman is a speaker for Janssen and Taro; he has received research, speaking and/or consulting support from a variety of companies including Galderma, GSK/Stiefel, Almirall, Leo Pharma, Baxter, Boeringer Ingelheim, Mylan, Celgene, Pfizer, Valeant, Abbvie, Cosmederm, Anacor, Astellas, Janssen, Lilly, Merck, Merz, Novartis, Qurient, National Biological Corporation, Caremark, Advance Medical, Suncare Research, Informa, UpToDate and National Psoriasis Foundation; and he is the founder and majority owner of www.DrScore.com and the founder and part owner of Causa Research, a company dedicated to enhancing patients' adherence to treatment. Dr Fleischer is a consultant for Kikaku America International and Exeltis; he was an Investigator for Abbvie, Galderma, Regeneron, and Eli Lilly and an employee of Merz. Dr Fleischer is currently an employee of Abbvie. Dr He disclosed no conflicts. |
Vol 79 - N° 1
P. 92-96 - juillet 2018 Retour au numéro
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