Approach to the selection of antihistamines in the treatment of allergodermatoses



Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Every third patient at a dermatologist’s appointment suffers from allergic dermatosis. Traditionally, in Russia this term includes diseases such as atopic dermatitis, contact dermatitis, eczema and urticaria. All diseases are based on immune-mediated allergic inflammation, accompanied by itching of varying degrees of intensity. Itching can affect work productivity, sleep quality and mood, aggravate skin diseases and lead to complications. The occurrence and maintenance of itching is caused by mechanical irritation, direct contact with allergens, exposure to chemical and physical factors, and the release of various mediators, in particular histamine. Antihistamines are used to control itching as monotherapy or an addition to topical treatment. Among non-sedative antihistamines, levocetirizine has a special place. Levocetirizine has a favorable pharmacological profile. Rapid development of the effect and optimal duration of action in combination with a low risk of drug interactions, good tolerability, absence of influence on cognitive and psychomotor functions and cardiac safety make levocetirizine the drug of first choice in the treatment of skin itching in allergic dermatoses. Real practice confirms the claimed characteristics of the medicine.

Full Text

Restricted Access

About the authors

Natalia M. Nenasheva

Federal State Budgetary Educational Institution of Further Professional Education "Russian Medical Academy of Continuous Professional Education" of the Ministry of Healthcare of the Russian Federation

Email: 1444031@gmail.com
ORCID iD: 0000-0002-3162-2510
SPIN-code: 3363-6170

PD, Professor, Head of the Department of Allergology and Immunology FSBEI FPE RMACPE MOH Russia

Россия, 125993, Moscow, Barrikadnaya Street, 2/1, bldg. 1

Aysa Yu. Nasunova

Federal State Budgetary Educational Institution of Further Professional Education "Russian Medical Academy of Continuous Professional Education" of the Ministry of Healthcare of the Russian Federation

Author for correspondence.
Email: aysanasunova@gmail.com
ORCID iD: 0009-0006-7116-9091
SPIN-code: 9297-8223

PhD, Assistant Professor of the Department Allergology and Immunology FSBEI FPE RMACPE MOH Russia

Россия, 125993, Moscow, Barrikadnaya Street, 2/1, bldg. 1

References

  1. de Monchy JG, Demoly P, Akdis CA, Cardona V, Papadopoulos NG, Schmid-Grendelmeier P, Gayraud J. Allergology in Europe, the blueprint. Allergy. 2013 Oct;68(10):1211-8. doi: 10.1111/all.12225. Epub 2013 Sep 21. PMID: 24053537.
  2. van de Veen, W; Akdis, M (2014). Mechanisms of immune regulation in allergy. In: Akdis, C A; Agache, I. EAACI Global Atlas of Allergy. Zurich: European Academy of Allergy and Clinical Immunology, 90-91.
  3. Genuneit J, Seibold AM, Apfelbacher CJ, Konstantinou GN, Koplin JJ, La Grutta S, Logan K, Perkin MR, Flohr C; Task Force ‘Overview of Systematic Reviews in Allergy Epidemiology (OSRAE)’ of the EAACI Interest Group on Epidemiology. Overview of systematic reviews in allergy epidemiology. Allergy. 2017 Jun;72(6):849-856. doi: 10.1111/all.13123. Epub 2017 Jan 24. PMID: 28052339.
  4. Lee HH, Patel KR, Singam V, Rastogi S, Silverberg JI. A systematic review and meta-analysis of the prevalence and phenotype of adult-onset atopic dermatitis. J Am Acad Dermatol. 2019 Jun;80(6):1526-1532.e7. doi: 10.1016/j.jaad.2018.05.1241. Epub 2018 Jun 2. PMID: 29864464.
  5. Kubanov АА, Bogdanova EV. Resources and performance rates of medical organizations providing medical care in the field of dermatovenereology in the Russian Federation in 2016–2022. Vestnik Dermatologii i Venerologii. 2023;99(4):18–40. doi: https://doi.org/10.25208/vdv12385.
  6. Langan SM, Irvine AD, Weidinger S. Atopic dermatitis. Lancet. 2020 Aug 1;396(10247):345-360. doi: 10.1016/S0140-6736(20)31286-1. Erratum in: Lancet. 2020 Sep 12;396(10253):758. doi: 10.1016/S0140-6736(20)31825-0. PMID: 32738956.
  7. The Russian Association of Allergologists and Clinical Immunologists, the Union of Pediatricians of Russia, the All-Russian Public Organization "Russian Society of Dermatovenerologists and Cosmetologists", the Interregional Public Organization "National Alliance of Dermatovenerologists and Cosmetologists. Clinical recommendations. Atopic dermatitis. 2024. (In Russ). Available from: https://cr.minzdrav.gov.ru/preview-cr/265_3. Accessed: 20.03.2025.
  8. Barbarot S, Auziere S, Gadkari A, Girolomoni G, Puig L, Simpson EL, Margolis DJ, de Bruin-Weller M, Eckert L. Epidemiology of atopic dermatitis in adults: Results from an international survey. Allergy. 2018 Jun;73(6):1284-1293. doi: 10.1111/all.13401. Epub 2018 Feb 13. PMID: 29319189.
  9. Schleimer RP, Berdnikovs S. Etiology of epithelial barrier dysfunction in patients with type 2 inflammatory diseases. J Allergy Clin Immunol. 2017 Jun;139(6):1752-1761. doi: 10.1016/j.jaci.2017.04.010. PMID: 28583447; PMCID: PMC5753806.
  10. Rozas-Muñoz E, Gamé D, Serra-Baldrich E. Allergic Contact Dermatitis by Anatomical Regions: Diagnostic Clues. Actas Dermosifiliogr (Engl Ed). 2018 Jul-Aug;109(6):485-507. English, Spanish. doi: 10.1016/j.ad.2017.05.011. Epub 2017 Oct 12. PMID: 29031485.
  11. Bains SN, Nash P, Fonacier L. Irritant Contact Dermatitis. Clin Rev Allergy Immunol. 2019 Feb;56(1):99-109. doi: 10.1007/s12016-018-8713-0. PMID: 30293200.
  12. Pesqué D, Aerts O, Bizjak M, Gonçalo M, Dugonik A, Simon D, Ljubojević-Hadzavdić S, Malinauskiene L, Wilkinson M, Czarnecka-Operacz M, Krecisz B, John SM, Balato A, Ayala F, Rustemeyer T, Giménez-Arnau AM. Differential diagnosis of contact dermatitis: A practical-approach review by the EADV Task Force on contact dermatitis. J Eur Acad Dermatol Venereol. 2024 Sep;38(9):1704-1722. doi: 10.1111/jdv.20052. Epub 2024 May 7. PMID: 38713001.
  13. The Russian Association of Allergologists and Clinical Immunologists, the Union of Pediatricians of Russia, the All-Russian Public Organization "Russian Society of Dermatovenerologists and Cosmetologists", the Interregional Public Organization "National Alliance of Dermatovenerologists and Cosmetologists". Clinical recommendations. Contact dermatitis. 2024. (In Russ). Available from: https://cr.minzdrav.gov.ru/preview-cr/213_3.
  14. Accessed: 20.03.2025.
  15. Johnston GA, Exton LS, Mohd Mustapa MF, Slack JA, Coulson IH, English JS, Bourke JF. British Association of Dermatologists' guidelines for the management of contact dermatitis 2017. Br J Dermatol. 2017 Feb;176(2):317-329. doi: 10.1111/bjd.15239. PMID: 28244094.
  16. The All-Russian public organization "Russian Society of Dermatovenerologists and Cosmetologists". Clinical recommendations. Eczema. 2024. (In Russ). Available from: https://cr.minzdrav.gov.ru/preview-cr/246_3. Accessed: 20.03.2025.
  17. Amar SM, Dreskin SC. Urticaria. Prim Care. 2008 Mar;35(1):141-57, vii-viii. doi: 10.1016/j.pop.2007.09.009. PMID: 18206722.
  18. Poonawalla T, Kelly B. Urticaria: a review. Am J Clin Dermatol. 2009;10(1):9-21. doi: 10.2165/0128071-200910010-00002. Erratum in: Am J Clin Dermatol. 2012 Jun 1;13(3):215. PMID: 19170406.
  19. The Russian Association of Allergologists and Clinical Immunologists, the Union of Pediatricians of Russia, the All-Russian Public Organization "Russian Society of Dermatovenerologists and Cosmetologists". Clinical recommendations. Urticaria. 2024. (In Russ). Available from: https://cr.minzdrav.gov.ru/view-cr/264_2. Accessed: 20.03.2025.
  20. Ben-Shoshan M, Kanani A, Kalicinsky C, Watson W. Urticaria. Allergy Asthma Clin Immunol. 2024 Dec 9;20(Suppl 3):64. doi: 10.1186/s13223-024-00931-6. PMID: 39654029; PMCID: PMC11629492.
  21. Fricke J, Ávila G, Keller T, Weller K, Lau S, Maurer M, Zuberbier T, Keil T. Prevalence of chronic urticaria in children and adults across the globe: Systematic review with meta-analysis. Allergy. 2020 Feb;75(2):423-432. doi: 10.1111/all.14037. Epub 2019 Oct 11. PMID: 31494963.
  22. Antigistaminny`e preparaty` v klinicheskoj praktike: Klinicheskoe rukovodstvo dlya vrachej / Pod redakciej N.M. Nenashevoj. -M.: Medkongress, 2024. – 96s.
  23. Church MK, Church DS. Pharmacology of antihistamines. Indian Journal of Dermatology. 2013 May;58(3):219-224. doi: 10.4103/0019-5154.110832. PMID: 23723474; PMCID: PMC3667286.
  24. Molimard M, Diquet B, Benedetti MS. Comparison of pharmacokinetics and metabolism of desloratadine, fexofenadine, levocetirizine and mizolastine in humans. Fundamental & Clinical Pharmacology. 2004 Aug;18(4):399-411. doi: 10.1111/j.1472-8206.2004.00254.x. PMID: 15312146.
  25. Kareva EN. Vybor antigistaminnogo preparata: vzglyad farmakologa. RMZH. 2016;12:811-816 (in Russ.).
  26. Rico S, Antonijoan R, Barbanoj M. Ebastine in the light of CONGA recommendations for the development of third-generation antihistamines. J Asthma Allergy. 2009 Aug 31;2:73-92. doi: 10.2147/jaa.s3108. PMID: 21437146; PMCID: PMC3048600.
  27. Bosma R, van den Bor J, Vischer HF, Labeaga L, Leurs R. The long duration of action of the second generation antihistamine bilastine coincides with its long residence time at the histamine H1 receptor. Eur J Pharmacol. 2018 Nov 5;838:107-111. doi: 10.1016/j.ejphar.2018.09.011. Epub 2018 Sep 7. PMID: 30201377.
  28. Grant JA, Riethuisen JM, Moulaert B, DeVos C. A double-blind, randomized, single-dose, crossover comparison of levocetirizine with ebastine, fexofenadine, loratadine, mizolastine, and placebo: suppression of histamine-induced wheal-and-flare response during 24 hours in healthy male subjects. Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology. 2002 Feb;88(2):190-197. doi: 10.1016/s1081-1206(10)61995-3. PMID: 11868924.
  29. Hair PI, Scott LJ. Levocetirizine: a review of its use in the management of allergic rhinitis and skin allergies. Drugs. 2006;66(7):973-96. doi: 10.2165/00003495-200666070-00017. PMID: 16740020.
  30. Devillier P, Roche N, Faisy C. Clinical pharmacokinetics and pharmacodynamics of desloratadine, fexofenadine and levocetirizine : a comparative review. Clinical Pharmacokinetics. 2008 ;47(4):217-230. doi: 10.2165/00003088-200847040-00001. PMID: 18336052.
  31. Dukhanin A.S. Pharmacological profile of antihistamines: focus on unwanted drug interactions // Russian Journal of Allergy. - 2020. - Vol. 17. - N. 4. - P. 46-56. doi: 10.36691/RJA1407
  32. Molimard M, Diquet B, Benedetti MS. Comparison of pharmacokinetics and metabolism of desloratadine, fexofenadine, levocetirizine and mizolastine in humans. Fundamental & Clinical Pharmacology. 2004 Aug;18(4):399-411. doi: 10.1111/j.1472-8206.2004.00254.x. PMID: 15312146.
  33. Tashiro M, Kato M, Miyake M, et al. Dose dependency of brain histamine H(1) receptor occupancy following oral administration of cetirizine hydrochloride measured using PET with [11C]doxepin. Human Psychopharmacology. 2009 Oct;24(7):540-548. doi: 10.1002/hup.1051. PMID: 19697300.
  34. GRLS, Listok-vklady`sh – informaciya dlya pacienta. Allerve`j, 5 mg, tabletki, pokry`ty`e plenochnoj obolochkoj. Available from: URL:https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=8ba99691-03c4-4dba-a254-93d932830ef4. Accessed: 20.03.2025.
  35. Instrukciya po medicinskomu primeneniyu lekarstvennogo preparata Allerve`j e`kspress, 5 mg, tabletki, dispergiruemy`e v polosti rta.
  36. Available from: URL:https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=d8b3682d-9729-40b7-a890-cedeb90e9286. Accessed: 20.03.2025.
  37. Kruglova LS, Lvov AN, Araviyskaya ER, Bakulev AL, Gadzhigoroeva AG, Galimova ES, Danilycheva IV, Elisyutina OG, Ziganshin OR, Ilina NI, Kokhan MM,
  38. Matushevskaya EV, Migacheva NB, Murashkin NN, Nemchaninova OB, Nenasheva NM, Olisova OYu, Pavlinova EB, Pritulo OA, Repetskaya MN, Samtsov AV,
  39. Sidorenko OA, Snarskaya ES, Sokolovsky EV, Tamrazova OB, Tataurshchikova NS, Fedenko ES, Fedotova NV, Shartanova NV, Yusupova LA. The use of
  40. Cetirizine and Levocetirizine in patients with chronic urticaria and other allergic dermatoses: issues of dosage increasing and long-term use. Resolution of
  41. the Advisory Board. Russian Journal of Allergy. 2022;19(3):388–403. DOI: https://doi.org/10.36691/RJA1574.
  42. Nordeng H, Wegler C, Lindqvist A, Melander E, Magnusson M, Gandia P, Panchaud A, Baranczewski P, Spigset O. Transfer of cetirizine/levocetirizine into human breast milk and estimation of drug exposure to infants through breastfeeding: A human lactation study from the ConcePTION project. Basic Clin Pharmacol Toxicol. 2024 Jan;134(1):153-164. doi: 10.1111/bcpt.13948. Epub 2023 Nov 13. PMID: 37811726.
  43. Gushchin I.S. A basis of multiple antiallergic effects of inverse H1-receptor agonists. PULMONOLOGIYA. 2008;(6):84-89. (In Russ.) https://doi.org/10.18093/0869-0189-2008-0-6-84-89.
  44. Godse KV. Updosing of antihistamines to improve control of chronic urticaria. Indian J Dermatol Venereol Leprol. 2010 Jan-Feb;76(1):61-2. doi: 10.4103/0378-6323.58684. PMID: 20061736.
  45. Sharma VK, Gupta V, Pathak M, Ramam M. An open-label prospective clinical study to assess the efficacy of increasing levocetirizine dose up to four times in chronic spontaneous urticaria not controlled with standard dose. J Dermatolog Treat. 2017 Sep;28(6):539-543. doi: 10.1080/09546634.2016.1246705. Epub 2017 Apr 25. PMID: 27779432.
  46. Staevska M, Popov TA, Kralimarkova T, Lazarova C, Kraeva S, Popova D, Church DS, Dimitrov V, Church MK. The effectiveness of levocetirizine and desloratadine in up to 4 times conventional doses in difficult-to-treat urticaria. J Allergy Clin Immunol. 2010 Mar;125(3):676-82. doi: 10.1016/j.jaci.2009.11.047. PMID: 20226302.
  47. Grant JA, Riethuisen JM, Moulaert B, DeVos C. A double-blind, randomized, single-dose, crossover comparison of levocetirizine with ebastine, fexofenadine, loratadine, mizolastine, and placebo: suppression of histamine-induced wheal-and-flare response during 24 hours in healthy male subjects. Ann Allergy Asthma Immunol. 2002 Feb;88(2):190-7. doi: 10.1016/S1081-1206(10)61995-3. PMID: 11868924.
  48. Podder I, Dhabal A, Chakraborty SS. Efficacy and Safety of Up-dosed Second-generation Antihistamines in Uncontrolled Chronic Spontaneous Urticaria: A Review. J Clin Aesthet Dermatol. 2023 Mar;16(3):44-50. PMID: 36950042; PMCID: PMC10027330.
  49. Iriarte Sotés P, Armisén M, Usero-Bárcena T, Rodriguez Fernández A, Otero Rivas MM, Gonzalez MT, Meijide Calderón A, Veleiro B; Urtigal, the Galician Group of Interest in Urticaria. Efficacy and Safety of Up-dosing Antihistamines in Chronic Spontaneous Urticaria: A Systematic Review of the Literature. J Investig Allergol Clin Immunol. 2021 Jul 26;31(4):282-291. doi: 10.18176/jiaci.0649. Epub 2020 Oct 8. PMID: 33030434.
  50. Guillén-Aguinaga S, Jáuregui Presa I, Aguinaga-Ontoso E, Guillén-Grima F, Ferrer M. Updosing nonsedating antihistamines in patients with chronic spontaneous urticaria: a systematic review and meta-analysis. Br J Dermatol. 2016 Dec;175(6):1153-1165. doi: 10.1111/bjd.14768. Epub 2016 Oct 19. PMID: 27237730.
  51. Cataldi M, Maurer M, Taglialatela M, Church MK. Cardiac safety of second-generation H1 -antihistamines when updosed in chronic spontaneous urticaria. Clin Exp Allergy. 2019 Dec;49(12):1615-1623. doi: 10.1111/cea.13500. Epub 2019 Oct 18. PMID: 31519068.
  52. Kruglova L.S., Tataurschikova N.S., Tipaeva E.V. Issues of long-term use of antihistamines // Pharmateca. - 2021. - Vol. 28. - N. 14. - P. 87-93. doi: 10.18565/pharmateca.2021.14.87-93.
  53. Simons FE; Early Prevention of Asthma in Atopic Children (EPAAC) Study Group. Safety of levocetirizine treatment in young atopic children: An 18-month study. Pediatr Allergy Immunol. 2007 Sep;18(6):535-42. doi: 10.1111/j.1399-3038.2007.00558.x. Epub 2007 Jun 11. PMID: 17561929.
  54. Kruglova LS, Masiukova SA, Abesadze GA. Modern antihistamines in comprehensive treatment of itching dermatoses. Russian Journal of Clinical Dermatology and Venereology. 2014;12(1):52‑58. (In Russ.).
  55. Scordamaglia F, Compalati E, Baiardini I, Scordamaglia A, Canonica GW. Levocetirizine in the treatment of allergic diseases. Expert Opin Pharmacother. 2009 Oct;10(14):2367-77. doi: 10.1517/14656560903193086. PMID: 19663743.
  56. Snidvongs K, Seresirikachorn K, Khattiyawittayakun L, Chitsuthipakorn W. Sedative Effects of Levocetirizine: A Systematic Review and Meta-Analysis of Randomized Controlled Studies. Drugs. 2017 Feb;77(2):175-186. doi: 10.1007/s40265-016-0682-0. PMID: 28070872.
  57. Podder I, Dhabal A, Chakraborty SS. Efficacy and Safety of Up-dosed Second-generation Antihistamines in Uncontrolled Chronic Spontaneous Urticaria: A Review. The Journal of Clinical and Aesthetic Dermatology. 2023 Mar;16(3):44-50. PMID: 36950042; PMCID: PMC10027330.
  58. Elseviers, Monique, et al., eds. Drug utilization research: methods and applications. John Wiley & Sons, 2024.
  59. Engeland A, Bjørge T, Klungsøyr K, Hjellvik V, Skurtveit S, Furu K. Trends in prescription drug use during pregnancy and postpartum in Norway, 2005 to 2015. Pharmacoepidemiol Drug Saf. 2018 Sep;27(9):995-1004. doi: 10.1002/pds.4577. Epub 2018 Jun 19. PMID: 29920833.
  60. Stephansson O, Granath F, Svensson T, Haglund B, Ekbom A, Kieler H. Drug use during pregnancy in Sweden - assessed by the Prescribed Drug Register and the Medical Birth Register. Clin Epidemiol. 2011 Feb 1;3:43-50. doi: 10.2147/CLEP.S16305. PMID: 21386973; PMCID: PMC3046184.
  61. Nordeng H, Wegler C, Lindqvist A, Melander E, Magnusson M, Gandia P, Panchaud A, Baranczewski P, Spigset O. Transfer of cetirizine/levocetirizine into human breast milk and estimation of drug exposure to infants through breastfeeding: A human lactation study from the ConcePTION project. Basic Clin Pharmacol Toxicol. 2024 Jan;134(1):153-164. doi: 10.1111/bcpt.13948. Epub 2023 Nov 13. PMID: 37811726

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright © ABV-press,



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies