Differential effects of new-generation H1-receptor antagonists in pruritic
dermatoses.
Author(s): Henz BM, Metzenauer P, O'Keefe E, Zuberbier T.
Affiliation(s): Department of Dermatology, Virchow Klinikum, Humboldt University, Berlin,
Germany.
Publication date & source: 1998, Allergy. , 53(2):180-3
In search of an improved treatment of pruritic dermatoses, we have studied
azelastine, a novel H1-receptor antagonist, during a 2-week treatment period,
using a double-blind, placebo-controlled design. The potent H1-antagonist
cetirizine was used for comparison. Symptoms were recorded daily by the patients
on a diary card, using a 4-point scale. The same parameters and adverse events
were evaluated at weekly intervals, and global improvement was evaluated at the
end of treatment. In all 230 evaluable patients with moderate to severe itching,
azelastine caused an overall significant improvement in comparison to placebo (P
= 0.02), with significance also for pruritus (P = 0.01 after 1 week and P = 0.02
after 2 weeks). Both drugs reduced itching more effectively in urticaria than in
atopic eczema. Azelastine was superior to cetirizine in reducing pruritus,
whereas cetirizine caused a more marked reduction of whealing. Both drugs rarely
caused fatigue and dry mouth, but taste perversion occurred only in
azelastine-treated patients (9.7%) and headaches only with cetirizine (10.4%).
Therefore, the two H1-blockers exert differential effects on pruritus verses
whealing and a distinctive adverse events pattern. The data also underline the
low efficacy of antihistamines in atopic eczema, compared to urticaria.
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