Comparison of cetirizine, ebastine and loratadine in the treatment of immediate mosquito-bite allergy.
BACKGROUND
People frequently experience whealing and delayed papules from mosquito bites. Whealing is mediated by antisaliva immunoglobulin (Ig)E antibodies and histamine. Cetirizine, ebastine and loratadine have earlier shown effects on mosquito-bite reactions but no comparative studies exist.


METHODS
A double-blind, placebo-controlled, cross-over study was performed with cetirizine 10 mg, ebastine 10 mg and loratadine 10 mg in 29 mosquito-bite-sensitive adults exposed to Aedes aegypti mosquito-bites. The size of the bite lesion and the intensity of pruritus (visual analog scale) were measured at 15 min and 2, 6 and 24 h.


RESULTS
Cetirizine and ebastine, but not loratadine, decreased significantly the size of whealing (P < 0.01) and accompanying pruritus (P < 0.001) compared to placebo. Cetirizine was most effective on pruritus but caused more often sedation than ebastine or loratadine. The delayed bite symptoms remained too faint for any statistical comparison.


CONCLUSIONS
This comparative study in mosquito-bite-sensitive adults shows that cetirizine and ebastine decrease significantly whealing and accompanying pruritus, and that cetirizine seems to be the most effective against pruritus.
Karppinen
A
A
Department of Dermatology, Tampere University Hospital and University of Tampere, Finland.
Kautiainen
H
H
Petman
L
L
Burri
P
P
Reunala
T
T
D000328:Adult; D000818:Animals; D002090:Butyrophenones / Q000627:therapeutic use*; D017332:Cetirizine / Q000627:therapeutic use*; D016292:Procedural Sedation; D018592:Cross-Over Studies; D009033:Culicidae; D004311:Double-Blind Method; D005387:Finland; D006634:Histamine H1 Antagonists / Q000627:therapeutic use*; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000188:drug therapy* / Q000209:etiology*; D007299:Insect Bites and Stings / Q000150:complications* / Q000188:drug therapy*; D017336:Loratadine / Q000627:therapeutic use*; D008875:Middle Aged; D010880:Piperidines / Q000627:therapeutic use*; D011537:Pruritus / Q000188:drug therapy / Q000209:etiology; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
D002090:Butyrophenones; D006634:Histamine H1 Antagonists; D010880:Piperidines; D017336:Loratadine; C058249:ebastine; D017332:Cetirizine