Background

Antihistamines are often used to treat pruritus associated with atopic dermatitis (AD) despite lack of evidence for their efficacy. The American Academy of Dermatology does not recommend the general use of antihistamines in the management of AD, although the value of short-term sedating antihistamine use for insomnia secondary to itch is recognized.

Objective

To assess the use of sedating and nonsedating antihistamines for AD in 2003-2012.

Methods

The National Ambulatory Medical Care Survey provided data on physician visits in 2003-2012. Sedating and nonsedating antihistamine use was identified at visits for AD.

Results

There were 990,000 annual visits for AD. Antihistamines were prescribed for AD in a significant proportion of visits across physician specialties (16%-44%). Dermatologists and pediatricians primarily used sedating antihistamines (58%-70%), whereas the majority of family/general practitioners, internists, and other specialists prescribed nonsedating antihistamines for AD (55%-100%)

Limitations

We were limited by the accuracy of AD diagnosis and medication recording.

Conclusions

Antihistamines are widely used for the treatment of AD. There is no high-level evidence to suggest that nonsedating antihistamines reduce itch in patients with AD or that sedating antihistamines provide benefit in controlling AD symptoms (except perhaps sleep and AD comorbidities, such as allergic rhinitis).

中文翻译：

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使用抗组胺药治疗特应性皮炎的评估

背景

尽管缺乏抗组胺药的疗效证据，但通常仍用于治疗与特应性皮炎（AD）相关的瘙痒症。尽管认识到短期镇静抗组胺药治疗继发于瘙痒的失眠症的价值，但美国皮肤科学院不建议在抗逆转录病毒治疗中一般使用抗组胺药。

客观的

评估2003-2012年镇静剂和非镇静剂抗组胺药在AD中的使用情况。

方法

全国门诊医疗调查提供了2003-2012年就诊医生的数据。在访问AD时已确定使用镇静剂和非镇静剂使用抗组胺药。

结果

AD的年访问量为990,000。在整个医学专科门诊中，抗组胺药的处方访视比例很高（16％-44％）。皮肤科医生和儿科医生主要使用镇静抗组胺药（58％-70％），而大多数家庭/普通科医生，内科医生和其他专家开具非镇静抗组胺药用于AD（55％-100％）

局限性

我们受到AD诊断和药物记录准确性的限制。

结论

抗组胺药广泛用于AD的治疗。没有高水平的证据表明非镇静抗组胺药可减轻AD患者的瘙痒，或镇静抗组胺药可有益于控制AD症状（也许睡眠和AD合并症，例如过敏性鼻炎除外）。