title: H1-antihistamines for chronic spontaneous urticaria: an abridged Cochrane Systematic Review.
abstract: BACKGROUND
  Chronic spontaneous urticaria is characterized by recurrent itchy wheals. First-line management is with H1-antihistamines.
  
  
  OBJECTIVE
  We sought to conduct a Cochrane Review of H1-antihistamines in the treatment of chronic spontaneous urticaria.
  
  
  METHODS
  A systematic search of major databases for randomized controlled trials was conducted.
  
  
  RESULTS
  We included 73 studies with 9759 participants; 34 studies provided outcome data for 23 comparisons. Compared with placebo, cetirizine 10 mg daily in the short and intermediate term (RR 2.72; 95% confidence interval [CI] 1.51-4.91) led to complete suppression of urticaria. Levocetirizine 20 mg daily was effective for short-term use (RR 20.87; 95% CI 1.37-317.60) as was 5 mg for intermediate-term use (RR 52.88; 95% CI 3.31-843.81). Desloratadine 20 mg was effective for the short term (RR 15.97; 95% CI 1.04-245.04) as was 5 mg in the intermediate term (RR 37.00; 95% CI 2.31-593.70). There was no evidence to suggest difference in adverse event rates between treatments.
  
  
  CONCLUSIONS
  Some methodological limitations were observed. Few studies for each comparison reported outcome data that could be incorporated in meta-analyses.
  
  
  CONCLUSIONS
  At standard doses, several antihistamines are effective and safe in complete suppression of chronic spontaneous urticaria. Research on long-term treatment using standardized outcome measures and quality of life scores is needed.
authors.affiliation: Department of Dermatology, Derby Teaching Hospitals National Health Service Foundation Trust, London Road Community Hospital, Derby, United Kingdom. Electronic address: maulinasharma@yahoo.co.uk.
authors.forename: Maulina
authors.initials: M
authors.lastname: Sharma
authors.affiliation: Centre for Technology Enabled Health Research, Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom.
authors.forename: Cathy
authors.initials: C
authors.lastname: Bennett
authors.affiliation: Institute of Primary Care and Public Health, Cardiff University, Cardiff, United Kingdom.
authors.forename: Ben
authors.initials: B
authors.lastname: Carter
authors.affiliation: Nottingham University Hospitals National Health Service Trust, Queen's Medical Centre, Nottingham, United Kingdom.
authors.forename: Stuart N
authors.initials: SN
authors.lastname: Cohen
mesh_terms: D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006633:Histamine Antagonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014581:Urticaria / Q000175:diagnosis* / Q000188:drug therapy* / Q000523:psychology
chemical_list: D006633:Histamine Antagonists
keywords: Cochrane; H1-antihistamines; chronic spontaneous urticaria; review; treatment