Synergistic Effect of H1-Antihistamines on Topical Corticosteroids for Pruritus in Atopic Dermatitis: A Systematic Review and Meta-Analysis

• Published in: Annals of dermatology Vol. 31; no. 4; pp. 420 - 425
• Main Authors: Hur, Min Seok, Choe, Yong Beom, Ahn, Kyu Joong, Lee, Yang Won
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Dermatological Association; The Korean Society for Investigative Dermatology 01.08.2019; 대한피부과학회
• Subjects: Original; 피부과학; Histamine H1 antagonists; atopic; Pruritus; Dermatitis; Meta-analysis
• ISSN: 1013-9087; 2005-3894; 2005-3894
• DOI: 10.5021/ad.2019.31.4.420

Although oral antihistamines (H1-histamine receptor antagonists) are the main treatment option for pruritus in general skin dermatosis, their effect in treating pruritus of atopic dermatitis (AD) has not yet been established. We conducted a systematic review and meta-analysis to evaluate the effectiveness of combined therapy of H1-antihistamines and topical steroids. We systematically searched MEDLINE, Embase, and CENTRAL databases for articles published from 1967 to 2015. We identified 1,206 studies and assessed their titles, abstract, and full-text. Random effects meta-analysis was used to calculate mean differences (MD) with 95% confidence intervals (CI). Two studies satisfying the inclusion criteria of antihistamine therapy with mandatory topical steroid use were selected. Comparing antihistamine monotherapy with combination therapy, patients treated with the addition of antihistamine to topical corticosteroids showed a statistically significant clinical improvement (standard MD, -0.24; 95% CI, -0.42 to -0.05; =0.01). H1-antihistamines may have a synergistic effect when combined with topical steroids by influencing various associative factors of chronic pruritus in AD.