2020
DOI: 10.1016/j.annemergmed.2020.05.025
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Intravenous Cetirizine Versus Intravenous Diphenhydramine for the Treatment of Acute Urticaria: A Phase III Randomized Controlled Noninferiority Trial

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Cited by 10 publications
(28 citation statements)
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“…Patients receiving cetirizine had a shorter amount of time at the treatment center compared with those receiving diphenhydramine (1.7 h vs 2.3 h, respectively) and fewer returned to the treatment center within 24 h ( n = 0 and n = 2, respectively; Table 2 ). A similar, phase 3 trial evaluated the non-inferiority of IV cetirizine 10 mg versus IV diphenhydramine 50 mg in 262 adults who presented with acute urticaria (with or without angioedema) that required H 1 antihistamines in EDs or UC centers [ 20 ]. For the primary efficacy endpoint of change in patient-rated pruritus score at baseline to 2 h after treatment administration, the mean change with IV cetirizine was − 1.6 and with IV diphenhydramine it was − 1.5, with the treatment difference of 0.1 (95% CI − 0.1, 0.3) between the two groups meeting the non-inferiority criteria (Table 2 ).…”
Section: Treatment Of Acute Urticariamentioning
confidence: 99%
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“…Patients receiving cetirizine had a shorter amount of time at the treatment center compared with those receiving diphenhydramine (1.7 h vs 2.3 h, respectively) and fewer returned to the treatment center within 24 h ( n = 0 and n = 2, respectively; Table 2 ). A similar, phase 3 trial evaluated the non-inferiority of IV cetirizine 10 mg versus IV diphenhydramine 50 mg in 262 adults who presented with acute urticaria (with or without angioedema) that required H 1 antihistamines in EDs or UC centers [ 20 ]. For the primary efficacy endpoint of change in patient-rated pruritus score at baseline to 2 h after treatment administration, the mean change with IV cetirizine was − 1.6 and with IV diphenhydramine it was − 1.5, with the treatment difference of 0.1 (95% CI − 0.1, 0.3) between the two groups meeting the non-inferiority criteria (Table 2 ).…”
Section: Treatment Of Acute Urticariamentioning
confidence: 99%
“…There are no phase 3 trials of IV diphenhydramine specifically for the treatment of angioedema. In the phase 3 non-inferiority trial of IV cetirizine versus IV diphenhydramine, 12% of the patients in each treatment group had urticaria and angioedema [ 20 ]. In a post hoc subgroup analysis of patients with urticaria and angioedema, for the primary endpoint of the change in patient-rated pruritus score from baseline to 2 h after treatment administration, the mean (SD) change with IV cetirizine was − 1.5 (1.1) and with IV diphenhydramine was − 1.4 (0.9) [ 28 ].…”
Section: Treatment Of Angioedemamentioning
confidence: 99%
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“…The first-generation H 1 antihistamines can cause hypotension at rapid intravenous administration and sedation which are counterproductive in anaphylaxis. Intravenous cetirizine, the only second-generation parenteral H 1 antihistamine, available in some countries, may be recommended in the treatment of acute urticaria [ 145 ], but as any other H 1 antihistamine should never replace intramuscular epinephrine as first-line therapy in anaphylaxis. An injectable H 2 antihistamine, also not life-saving in anaphylaxis, is sometimes used.…”
Section: Management Of Anaphylaxismentioning
confidence: 99%