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Antihistamines in the Management of Pediatric Allergic Rhinitis: A Systematic Review

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Abstract

Background

The clinical benefit of newer antihistamines (AHs) versus other active treatments has not been assessed in pediatric patients with allergic rhinitis.

Methods

A systematic literature search was performed in MEDLINE, SCOPUS, and the Cochrane Central Register of Controlled Trials from inception through August 2020. Randomized controlled trials (RCTs) comparing newer with older AHs, corticosteroids, or montelukast were included. The Cochrane Risk of Bias Tool was used for quality assessment.

Results

Out of 10,656 citations, 16 RCTs (N = 1653) with a duration from 10 days to 3 months were included. When compared with older-generation AHs, the administration of newer AHs did not confer significant benefit and appeared less effective compared with intranasal corticosteroids. However, newer AHs were more potent in achieving symptom control compared with montelukast. Data regarding quality of life were generally missing. The incidence of adverse events was low in all treatment groups. The included RCTs were characterized by moderate risk of bias.

Conclusions

Newer AHs are effective in symptom control and well tolerated in the pediatric population. However, inadequate reporting, variation in outcome measures, and a paucity of sufficient randomized comparisons precluded us from quantifying the relative efficacy of newer AHs compared with other treatment options.

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Authors and Affiliations

  1. Pediatrics Working Group, Society of Junior Doctors, 5 Menalou Str, Maroussi, 15123, Athens, Greece

    Lilly Velentza, Zinovia Maridaki, Evangelia Blana & Michael Miligkos

  2. First Department of Pediatrics, National and Kapodistrian University of Athens, Athens, Greece

    Michael Miligkos

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  1. Lilly Velentza
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Contributions

Conceptualization of the study and design: LV, MM; screening of papers: LV, ZM, EB; data extraction: LV, MM; general supervision of the research team: MM; manuscript drafting and final approval: all authors.

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Correspondence to Lilly Velentza.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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All data generated or analysed during this study are included in this published article [and its supplementary information files].

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Velentza, L., Maridaki, Z., Blana, E. et al. Antihistamines in the Management of Pediatric Allergic Rhinitis: A Systematic Review. Pediatr Drugs 22, 673–683 (2020). https://doi.org/10.1007/s40272-020-00419-x

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