People with eczema who use antihistamines to manage their symptoms are being advised that the drugs likely offer no meaningful benefit and may increase harms, according to a new study.
Study findings on antihistamines for eczema
Researchers in Canada reviewed 47 trials involving more than 6,200 children and adults with moderate to severe eczema. They found that, compared with a placebo, antihistamines led to a “clinically unimportant reduction” in eczema severity and itchiness. The study also suggests antihistamines may “not reduce sleep disturbance” or eczema flare-ups.
First-generation drugs, which often cause drowsiness, may increase cognitive impairment and could lead to patients discontinuing treatment due to side effects.
Implications for UK patients
Eczema, also known as atopic dermatitis, affects around one in five children and one in ten adults in the UK. According to researchers, about one in five eczema patients in the UK use antihistamines. The National Institute for Health and Care Excellence (Nice) does not recommend antihistamines for routine management of the condition. However, they are sometimes offered if flare-ups are linked to hives or another allergic reaction, and short-term use of sedative antihistamines can help those whose itching severely disturbs sleep.
Experts said the findings address “longstanding uncertainty” about the role of antihistamines in eczema treatment and called for updated guidance.
Published in the BMJ
The findings, published in the BMJ, show that antihistamines “likely do not” improve patient outcomes and “while probably increasing harms”. The researchers added: “Our findings do not support their use in routine atopic dermatitis management. We have provided a foundation for an evidence-based change in practice, supporting the development of updated atopic dermatitis guidelines that prioritise efficacy, safety, and patient-centred care.”
