Cochrane · systematic review · CD012167
Oral H1 antihistamines as ‘add‐on’ therapy to topical treatment for eczema
Matterne, U, Böhmer, MM, Weisshaar, E, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
SkinAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
25
current version
GRADE rated
16
No studies
8
Included studies
NR
No studies 8 · 32%Ungraded 1 · 4%Very low 0 · 0%Low 9 · 36%Moderate 7 · 28%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Cetirizine 0.5 mg/kg/d versus placebo (18‐month intervention)
Population: children with eczema
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome 1. Mean change in patient‐assessed symptoms Pruritus was assessed once as part of SCORAD Cetirizine 0.5 mg/kg/d vs placebo (18‐month intervention) | no estimate extracted | NR | No studies |
Primary outcome 2. Proportion of participants reporting adverse effects and serious adverse events throughout the study period Cetirizine 0.5 mg/kg/d vs placebo (18‐month intervention) | RR 0.68 [0.46, 1.01] | 1 study · 795 participants | Moderate Downgraded: risk of bias |
Secondary outcome 1. Mean change in physician‐assessed clinical signs Measured by SCORAD Cetirizine 0.5 mg/kg/d vs placebo (18‐month intervention) | no estimate extracted | 1 study · 795 participants | Moderate Downgraded: risk of bias |
Secondary outcome 2. Mean change in quality of life Cetirizine 0.5 mg/kg/d vs placebo (18‐month intervention) | no estimate extracted | NR | No studies |
Secondary outcome 3. Number of eczema flares, measured by, for example, ‘escalation of treatment’ or ‘use of topical anti‐inflammatory medications’ Cetirizine 0.5 mg/kg/d vs placebo (18‐month intervention) | no estimate extracted | 1 study · 795 participants | Moderate Downgraded: risk of bias |
Cetirizine 10 mg/d versus placebo (4‐week intervention)
Population: adults with eczema
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome 1. Mean change in patient‐assessed symptoms Pruritus was assessed once as part of SCORAD and once by patient case report form (CRF) Cetirizine 10 mg/d vs placebo (4‐week intervention) | no estimate extracted | 1 study · 84 participants | Low Downgraded: risk of bias, imprecision |
Primary outcome 2. Proportion of participants reporting adverse effects and serious adverse events throughout the study period Cetirizine 10 mg/d vs placebo (4‐week intervention) | RR 1.11 [0.5, 2.45] | 1 study · 84 participants | Low Downgraded: risk of bias, imprecision |
Secondary outcome 1. Mean change in physician‐assessed clinical signs Total sum of 4 symptoms (signs) scores, each measured on 4‐point Likert scale (0 = absent; 3 = severe) Cetirizine 10 mg/d vs placebo (4‐week intervention) | no estimate extracted | 1 study · 84 participants | Low Downgraded: risk of bias, imprecision |
Secondary outcome 2. Mean change in quality of life Cetirizine 10 mg/d vs placebo (4‐week intervention) | no estimate extracted | NR | No studies |
Secondary outcome 3. Number of eczema flares, measured by, for example, ‘escalation of treatment’ or ‘use of topical anti‐inflammatory medications’ Cetirizine 10 mg/d vs placebo (4‐week intervention) | no estimate extracted | 1 study · 84 participants | Low Downgraded: risk of bias, imprecision |
Fexofenadine 120 mg/d versus placebo (1‐week intervention)
Population: adults with eczema
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome 1. Mean change in patient‐assessed symptoms This outcome was measured as the mean change in patient‐assessed pruritus (range 0 to 8) between baseline and the night of day 6 Fexofenadine 120 mg/d vs placebo (1‐week intervention) | no estimate extracted | 1 study · 400 participants | Moderate Downgraded: risk of bias, indirectness |
Primary outcome 2. Proportion of participants reporting adverse effects and serious adverse events throughout the study period Fexofenadine 120 mg/d vs placebo (1‐week intervention) | RR 1.05 [0.74, 1.5] | 1 study · 411 participants | Moderate Downgraded: risk of bias, indirectness |
Secondary outcome 1. Mean change in physician‐assessed clinical signs This outcome was assessed as investigator‐assessed change in the ratio of pruritus area to body surface area Fexofenadine 120 mg/d vs placebo (1‐week intervention) | no estimate extracted | 1 study · 1 participants | Moderate Downgraded: risk of bias, indirectness |
Secondary outcome 2. Mean change in quality of life Fexofenadine 120 mg/d vs placebo (1‐week intervention) | no estimate extracted | NR | No studies |
Secondary outcome 3. Number of eczema flares, measured by, for example, ‘escalation of treatment’ or ‘use of topical anti‐inflammatory medications’ Amount of 0.1% hydrocortisone butyrate cream used during the study Fexofenadine 120 mg/d vs placebo (1‐week intervention) | no estimate extracted | 1 study · 1 participants | Moderate Downgraded: risk of bias, indirectness |
Loratadine 10 mg/d versus placebo (4‐week intervention)
Population: male and female adults aged 15 years and older with eczema
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome 1. Mean change in patient‐assessed symptoms Reduction in pruritus on 100‐mm VAS from baseline Loratadine 10 mg/d vs placebo (4‐week intervention) | no estimate extracted | 1 study · 28 participants | Low Downgraded: risk of bias, imprecision |
Primary outcome 2. Proportion of participants reporting adverse effects and serious adverse events throughout the study period Loratadine 10 mg/d vs placebo (4‐week intervention) | RR 0.25 [0.01, 5.76] | 1 study · 28 participants | Low Downgraded: risk of bias, imprecision |
Secondary outcome 1. Mean change in physician‐assessed clinical signs SCORAD Loratadine 10 mg/d vs placebo (4‐week intervention) | no estimate extracted | 1 study · 28 participants | Low Downgraded: risk of bias, imprecision |
Secondary outcome 2. Mean change in quality of life Loratadine 10 mg/d vs placebo (4‐week intervention) | no estimate extracted | NR | No studies |
Secondary outcome 3. Number of eczema flares, measured by, for example, ‘escalation of treatment’ or ‘use of topical anti‐inflammatory medications’ Loratadine 10 mg/d vs placebo (4‐week intervention) | no estimate extracted | NR | No studies |
Loratadine 10 mg/d versus placebo (2‐week intervention)
Population: male and female adults with eczema
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome 1. Mean change in patient‐assessed symptoms VAS pruritus 10 cm Loratadine 10 mg/d vs placebo (2‐week intervention) | no estimate extracted | 1 study · 71 participants | Low Downgraded: imprecision |
Primary outcome 2. Proportion of participants reporting adverse effects and serious adverse events throughout the study period Loratadine 10 mg/d vs placebo (2‐week intervention) | no estimate extracted | 1 study · 73 participants | Ungraded |
Secondary outcome 1. Physician‐assessed clinical signs Number for whom treatment success was judged as good or very good Loratadine 10 mg/d vs placebo (2‐week intervention) | RR 2.04 [0.99, 4.2] | 1 study · 73 participants | Low Downgraded: imprecision |
Secondary outcome 2. Mean change in quality of life Loratadine 10 mg/d vs placebo (2‐week intervention) | no estimate extracted | NR | No studies |
Secondary outcome 3. Number of eczema flares, measured by, for example, ‘escalation of treatment’ or ‘use of topical anti‐inflammatory medications’ Loratadine 10 mg/d vs placebo (2‐week intervention) | no estimate extracted | NR | No studies |