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Customized antihistamine combinations and vigilant monitoring are crucial in treating chronic urticaria for best results.
Pairing antihistamines (anti-allergic medicines) not only boosts effectiveness but may also reduce safety risks, making it a viable option for managing chronic urticaria, summarized a review published in the “Indian Journal of Dermatology, Venereology and Leprology”. The benefits and safety of combining H1 antihistamines for urticaria treatment have remained uncertain—until now. This scoping review by Min Luo et al. delved into the evidence surrounding this combination therapy, evaluating its effectiveness and potential risks.
The review analyzed data from key medical databases, including Web of Science, PubMed and the Cochrane Central Register, selecting 109 studies from an initial pool of nearly 12,887. These studies involved 11,435 patients and spanned across 11 types of urticaria, revealing 43 unique antihistamine combinations, such as Mizolastine and Cyproheptadine, Loratadine and Cetirizine, Levocetirizine and Ebastine, and so on. Strikingly, 94 studies indicated that combination therapy outperformed monotherapy in treating urticaria.
Additionally, while 67 studies reported adverse drug reactions (ADRs), combination treatments were linked to fewer side effects in 32 cases. Frequent ADRs like drowsiness, fatigue and dry mouth were usually mild and lessened when the therapy stopped. Serious reactions were rare, with side effect rates in the treatment group extending from 0%-21%, compared to 0.5%-75% in the control group. Combining antihistamines enhances effectiveness and may lower safety risks for chronic urticaria, though careful monitoring is advised.
Indian Journal of Dermatology, Venereology and Leprology
Efficacy and safety of combinations of H1 antihistamines in the treatment of urticaria: A scoping review
Min Luo et al.
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