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Cited by 107Asthma and respiratory diseasesMast cells and histamineAllergic Rhinitis and Sensitization

Effects of antihistamines in adult asthma: a meta-analysis of clinical trials

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Van Ganse, E, Kaufman, L, Derde, MP, Yernault, JC, Delaunois, L, Vincken, W·1997·European Respiratory Journal
DOI 10.1183/09031936.97.10102216
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Abstract

A meta-analysis of clinical trials of antihistamines was performed to assess the risk-benefit ratio of this therapeutic class in asthma. Double-blind randomized placebo-controlled trials assessing lung function changes under repeated use of antihistamine in adult asthma were selected, and the quality of studies was scored. Morning peak expiratory flow rate (PEFR) was the primary outcome: an effect size was computed for each study, with a 95% confidence interval (95% CI), and a mean effect size was computed, combining all studies. Effect sizes were also determined for secondary outcomes: evening PEFR, forced expiratory volume in one second (FEV1) and daily use of inhaled beta-agonists. Nineteen studies were included in the meta-analysis. Mean quality score of studies was 59.4%; asthma was generally uncontrolled at study inclusion. Altogether, 582 antihistamine-treated and 557 placebo-treated asthma patients were evaluable. Antihistamines had little effect on airway calibre (mean increase in morning PEFR: 13 L x min(-1); 95 CI: 8-18 L x min(-1)) and on use of inhaled beta-agonists (mean reduction in daily use: 0.4 doses; 95% CI: 0-0.8 doses). Sedation occurred more often with antihistamines than with placebo (p<0.001); additional side-effects were mentioned, including weight gain, altered taste, headache and dry mouth. Respiratory and systemic effects observed after repeated use of antihistamines do not support the use of these medications in the treatment of asthma; better designed studies could affect this appraisal.

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  • Despite improvement in asthma symptoms, oral H1 antihistamines have failed to show significant improvements in objective pulmonary function testing and peak expiratory flow.

    “Despite improvement in asthma symptoms, objective measures using pulmonary function testing and peak expiratory flow have failed to demonstrate significant improvements.1804-1806”

    From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [1806]

    The Results report statistically significant, though small, improvements in both morning and evening peak expiratory flow, contrary to the claim that peak expiratory flow failed to improve significantly. The FEV1 result was not statistically significant, and the Discussion says symptom scores could not be combined in the meta-analysis. Page numbers are unavailable in our copy. (LLM, conf=0.90)

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Cites

Flagged first, then by citations

1 of the 44 references couldn’t be matched to a known paper.

Research works printed but not linked: 5

  1. Auty RM. Problems with the identification of new antial- lergic drugs. Pharmakotherapie 1981; 6: 268-274.
  2. Grant SM, Goa KL, Fitton A, Sorkin EM. Ketotifen. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in asthma and allergic disorders. Drugs 1990; 40: 412-448.
  3. EAACI Position Paper. The clinical safety of H 1 -recep- tor antagonists. Allergy 1996; 51: 666-675.
  4. Azelastine-Asthma Study Group -AASG-. An evalua- tion of the efficacy and safety of azelastine in patients with chronic asthma. J Allergy Clin Immunol 1996; 97: 1218-1224.
  5. Tinkelman DG, Bucholtz GA, Kemp JP, et al. Evaluation of the safety and efficacy of multiple doses of azelas- tine in adult patients with bronchial asthma overtime. Am Rev Respir Dis 1990; 141: 569-574.

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Authors
Van Ganse, E., Kaufman, L., Derde, M., Yernault, J., Delaunois, L., & Vincken, W.
Affiliations
Lyon 1 Université (FR)
Venue
European Respiratory Journal
Publisher
European Respiratory Society (ERS)
Published
1997-10-01
Volume
10
Issue
10
Pages
2216-2224
ISSN
  • 0903-1936 (ISSN-L)
  • 1399-3003
DOI
10.1183/09031936.97.10102216
OpenAlex
W2114259968
Cited by
107
References
44
Citations by year
2026: 2 · 2025: 1 · 2023: 3 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 2 · 2018: 3 · 2017: 1 · 2016: 2 · 2015: 2 · 2014: 3 · 2013: 5 · 2012: 1
FWCI
0.80
Type
journal article
Language
en
Open access
Locations
  • European Respiratory Journal (publishedVersion)
  • PubMed (publishedVersion)
  • Digital Access to Libraries (Université catholique de Louvain (UCL), l'Université de Namur (UNamur) and the Université Saint-Louis (USL-B)) (submittedVersion)
  • Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Life Sciences › Immunology and Microbiology › Immunology › Mast cells and histamine
  • Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
Keywords
antihistamines, adult asthma, peak expiratory flow, lung function, airway caliber, sedation, adverse drug reactions, risk-benefit ratio
MeSH terms
Adolescent, Adult, Aged, Asthma, Double-Blind Method, Drug Therapy, Combination, Female, Histamine H1 Antagonists, Humans, Male, Middle Aged, Respiratory Function Tests, Reproducibility of Results, Confidence Intervals, Randomized Controlled Trials as Topic, Treatment Outcome

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