Antihistamines in asthma

Holgate, Stephen T.; Finnerty, J.P.

doi:10.1016/0091-6749(89)90035-3

Cited by 82 publications

(32 citation statements)

References 83 publications

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“…This property, combined with early reports that new antihistamines may have specific anti-allergic properties in addition to H 1 -blocking activity, has led to development in asthma therapy [8][9][10]. To date, clinical trials have delivered contradictory results, and the matter is still the subject of debate [11,12]. Meta-analysis is the statistical analysis of a large collection of results from individual studies for the purpose of integrating independent research results, and the methods are clearly defined [13][14][15].…”

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confidence: 99%

Effects of antihistamines in adult asthma: a meta-analysis of clinical trials

Ganse¹,

Kaufman²,

Derde³

et al. 1997

Eur Respir J

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A meta-analysis of clinical trials of antihistamines was performed to assess the risk-benefit ratio of this therapeutic class in asthma. Double-blind randomized placebo-controlled trials assessing lung function changes under repeated use of antihistamine in adult asthma were selected, and the quality of studies was scored. Morning peak expiratory flow rate (PEFR) was the primary outcome: an effect size was computed for each study, with a 95% confidence interval (95% CI), and a mean effect size was computed, combining all studies. Effect sizes were also determined for secondary outcomes: evening PEFR, forced expiratory volume in one second (FEV1) and daily use of inhaled β-agonists.Nineteen studies were included in the meta-analysis. Mean quality score of studies was 59.4%; asthma was generally uncontrolled at study inclusion. Altogether, 582 antihistamine-treated and 557 placebo-treated asthma patients were evaluable. Antihistamines had little effect on airway calibre (mean increase in morning PEFR: 13 L·min -1 ; 95 CI: 8-18 L·min -1 ) and on use of inhaled β-agonists (mean reduction in daily use: 0.4 doses; 95% CI: 0-0.8 doses). Sedation occurred more often with antihistamines than with placebo (p<0.001); additional side-effects were mentioned, including weight gain, altered taste, headache and dry mouth.Respiratory and systemic effects observed after repeated use of antihistamines do not support the use of these medications in the treatment of asthma; better designed studies could affect this appraisal.

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confidence: 99%

Effects of antihistamines in adult asthma: a meta-analysis of clinical trials

Ganse¹,

Kaufman²,

Derde³

et al. 1997

Eur Respir J

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“…It is considered a major mediator in the early allergic reaction, and may play a role in the late-phase reaction. 15 Elevated histamine levels have been found in the bronchoalveolar lavage fluid, plasma, and urine of patients with asthma and patients undergoing inhaled-antigen provocation. [16][17][18] Nevertheless, studies us- ing first-generation H 1 -receptor antagonists demonstrated minimal benefit in asthma.…”

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confidence: 99%

Montelukast, a Leukotriene Receptor Antagonist, in Combination With Loratadine, a Histamine Receptor Antagonist, in the Treatment of Chronic Asthma

Reicin

White²,

Weinstein³

et al. 2000

Arch Intern Med

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“…Histamine concentrations in bronchoalveolar lavage from allergic asthmatics are higher than those from allergic rhinitics or healthy individuals and histamine can contribute to the airway hyperreactivity seen in asthmatic patients [12,13]. Those patients receiving effective asthma medication release less histamine than those not receiving treatment [14].…”

Section: Antihistaminesmentioning

confidence: 99%

Novel Therapies for Asthma - Advances and Problems

Walsh¹

2005

CPD

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It is now widely accepted that airway inflammation is the key factor underlying the pathogenesis of asthma. While corticosteroids remain the most important anti-inflammatory treatment for asthma they are rather non-specific in their actions. Their use also raises concerns over side effects and compliance issues, particularly in children and adolescents. There is therefore much effort being made to develop novel more specific and safer therapy for asthma. Efforts are being made to improve existing drugs together with the use of combination therapy with anti-histamines and leukotriene antagonists. An important area for potential advances in glucocorticoid (GC) development include the elucidation of the crystal structure of the GC receptor ligand-binding domain that may provide vital information in dissociating the anti-inflammatory effects of GCs from unwanted side-effects. Other areas include the development of humanised monoclonal antibodies for asthma therapy including those against IgE, IL-4 and IL-5 together with the inhibition of adhesion pathways and/or chemokines responsible for inflammatory cell accumulation in the asthmatic lung. The potential for immunotherapy using T cell peptide epitopes or DNA-based vaccines and the use of anti-inflammatory cytokines such as IL-10 or IFN-gamma are discussed. Several avenues of research are currently underway in an attempt to define mechanisms by which pro-inflammatory cells such as eosinophils can be safely removed from the asthmatic lung through apoptosis induction and their subsequent ingestion by phagocytes. Novel strategies include elucidation of the intracellular pathways controlling granulocyte apoptosis and the receptor mediated events employed by macrophages and bronchial epithelial cells in the recognition and removal of apoptotic cellular corpses. This paper will provide an overview of both the potential and shortcomings of these diverse approaches to drug development for asthma.

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Antihistamines in asthma

Cited by 82 publications

References 83 publications

Effects of antihistamines in adult asthma: a meta-analysis of clinical trials

Effects of antihistamines in adult asthma: a meta-analysis of clinical trials

Montelukast, a Leukotriene Receptor Antagonist, in Combination With Loratadine, a Histamine Receptor Antagonist, in the Treatment of Chronic Asthma

Novel Therapies for Asthma - Advances and Problems

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