title: No high level evidence to support the use of oral H1 antihistamines as monotherapy for eczema: a summary of a Cochrane systematic review.
abstract: BACKGROUND
  The most important symptom as well as one of the major diagnostic criteria for eczema is itch. Although oral antihistamines continue to be prescribed for people with eczema, it is unclear if they are effective and safe in relieving itch and skin lesions. We sought to evaluate the available evidence on effectiveness of oral antihistamines (H1 antagonists) as monotherapy in children and adults with eczema.
  
  
  METHODS
  Searches included 10 databases and trial registers as well as conference proceedings (January 2014). Randomised controlled trials that assessed the effects of oral H1 antihistamines as monotherapy in children and adults with eczema were included.
  
  
  RESULTS
  Our searches retrieved 757 references, but no randomised controlled trial met our inclusion criteria. Most studies allowed concomitant treatments, making the assessment of the individual effects of oral H1 antihistamines impossible.
  
  
  CONCLUSIONS
  There is currently no high-level evidence to support or refute the efficacy or safety of oral H1 antihistamines used as monotherapy for eczema. A further review of studies that assesses the effects of oral H1 antihistamines as 'add-on' therapy together with concomitant treatments is warranted to determine the beneficial effects of this group of medications in the treatment of eczema.
authors.affiliation: Department of Dermatology, B1-Q, Leiden University Medical Centre, Leiden, the Netherlands. e.j.van_zuuren@lumc.nl.
authors.forename: Esther J
authors.initials: EJ
authors.lastname: van Zuuren
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Apfelbacher
authors.forename: Zbys
authors.initials: Z
authors.lastname: Fedorowicz
authors.forename: Aldrin
authors.initials: A
authors.lastname: Jupiter
authors.forename: Uwe
authors.initials: U
authors.lastname: Matterne
authors.forename: Elke
authors.initials: E
authors.lastname: Weisshaar
mesh_terms: D000284:Administration, Oral; D000328:Adult; D002648:Child; D004485:Eczema / Q000188:drug therapy*; D006634:Histamine H1 Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D016896:Treatment Outcome
chemical_list: D006634:Histamine H1 Antagonists