Therapeutic effect of loratadine on pruritus in patients with atopic dermatitis

Abstract

The aim of the study was to assess the therapeutic efficacy of loratadine on pruritus in patients with atopic dermatitis, considering the patients' sensation of itch. Sixteen patients, mean age 24.8 years, with moderate or severe atopic dermatitis were included in a double-blind and placebo-controlled study with a six-period, multi-crossover design. The patients were given 10 mg loratadine or placebo every day, alternating between loratadine and placebo every 2 weeks. The degree of pruritus during the day and during the night was recorded by the patients every morning and every evening, respectively, on a 10-cm visual analog scale. The study detected a significant effect of loratadine, as compared with placebo, on pruritus during the day, pruritus during the night, and severity of rash. At least nine of the 16 patients included were classified as responders and only one as a nonresponder to loratadine treatment. It is concluded that loratadine may be tried as an adjuvant therapy in the management of severe and moderate atopic dermatitis, in patients complaining of pruritus.

Antihistamines in the Treatment of Atopic Dermatitis

“…No significant difference between fexofenadine and placebo in the incidence of adverse events was identified. 47 Loratadine, another potent nonsedative H 1 antihistamine, showed a reduction of pruritus and inflammation in two studies 48,49 of patients with AD, while another study 50 did not substantiate loratadine's antipruritic effects. Langeland et al 48 found a significant effect with loratadine in patients with moderate and severe AD compared with placebo on pruritus during the day, pruritus during the night, and severity of the rash.…”

Guidelines of care for atopic dermatitis

“…Reported improvements in disease severity and quality of life may be due primarily to promotion of restful sleep rather than a reduction in symptoms. [104][105][106][107][108][109][110][111] In an evidence-based review of the literature from 1966 to 1999, Klein and Clark 104 remarked on the paucity of proper clinical trials and concluded that there is no evidence to support the efficacy of non-sedating antihistamines in AD. Antihistamines are safe and not associated with significant adverse effects, even in very young patients.…”

“…Antihistamines are safe and not associated with significant adverse effects, even in very young patients. [106][107][108][109][110][111] Many patients with AD also have accompanying urticaria, dermatographism, and allergic rhinoconjunctivitis, and therefore they may be benefited by the use of antihistamines for these concurrent medical problems. …”

Die systemische Therapie im Behandlungskonzept des atopischen Ekzems

“…In doppelblinden, placebokontrollierten Studien zeigten Erhebungen älteren Datums keine signifikante Wirkung nicht-sedierender Antihistaminika [4,5]. Neuere Studien wollen hingegen eine Wirksamkeit nachweisen [6,7]. Nach unserer klinischen Erfahrung zeigen die Patienten sehr starke interindividuelle Variationen im Ansprechen auf Antihistaminika.Während bei einigen Patienten selbst die stärkeren sedierenden Antihistaminika keinen juckreizlindernden Effekt hervorrufen, zeigt sich ein sedativer Effekt und eine Juckreizreduktion bei anderen Patienten schon auf nichtsedierende Antihistaminika.…”