Atopic known as eczema) and of sleep.

Atopic diseases in children

In recent decades, atopic
diseases, including atopic dermatitis also known as eczema) and   of
sleep. Although
the association between AD and AR is known for a long time, pathogenetic interrelationships
are incompletely understood and are the subject of controversial debates.3

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Antihistamines in children

Antihistamines are an
established first-line treatment for AR and are widely prescribed in infants
for allergic symptoms.4 In the few years several new antihistamines
have been introduced onto the market while others have been withdrawn. The
proarrhythmic effect of some antihistamines became known, leading to the
voluntary removal of terfenadine and astemizole by their manufacturers. With
general increase in knowledge about adverse effects, much more information is
available on the safety and efficacy of these drugs in atopic children. Results from the Early
Treatment of the Atopic Child (ETAC), over the past several years program have
provided clinicians with a great deal of information about antihistamines in
toddlers.5

The second generation
antihistamines are selective for peripheral H1 receptors and are associated
with less sedation and anticholinergic effects compared to the non-selective
first generation antihistamines. The current second
generation agent (cetirizine, fexofenadine and loratadine) lack the cardiotoxic
effects of the first peripherally-selective agents, terfenadine and astemizole.5

Fexofenadine in atopic diseases

Clinical trials are available that support the
safety and efficacy of fexofenadine, a second generation antihistamine, in the
treatment of AD and AR in children.

Atopic dermatitis

Fexofenadine is
a non-sedating antihistamine that in help offset daytime itching without somnolence.
Nakagawa H et al., conducted a multicenter, randomised, double-blind
study in patients aged 7 to 15 years. Total 190 patients were enrolled in the
study.  Patients received fexofenadine 30
mg bid (7 to 11 years), 60 mg bid (12 to 15 years) or ketotifen fumarate dry
syrup 1 mg bid. The mean changes in itching scores were -0.50 (95% CI, -0.61 to
-0.38) in the fexofenadine group and -0.58 (95% CI, -0.70 to -0.45) in the
ketotifen group. This confirmed that fexofenadine was effective for relief of
pruritus associated with atopic dermatitis in paediatric patients.6

 

Allergic rhinitis

AR is one of the most
common clinical conditions in children.7 Antihistamines are well-known
first-line treatment for AR and are widely prescribed in infants for allergic
symptoms.

Hampel FC et al., conducted a multicenter,
randomised, placebo-controlled study to evaluate the safety and tolerability of
fexofenadine hydrochloride in children aged 6 months to 2 years with AR. The
study concluded that 15 or 30 mg of fexofenadine, given for a mean duration of
8 days is well tolerated, with a good safety profile, in children aged 6 months
to 2 years with AR. 4

 

Meltzer EO et al., conducted
a pooled analysis of three studies to evaluate the safety and efficacy of
fexofenadine in children with seasonal allergic rhinitis. Data were pooled from
three, double-blind, randomised, placebo-controlled, parallel-group, 2-week
trials in children (6–11 year) with seasonal allergic rhinitis. The study
concluded that fexofenadine is safe and effective in reducing all seasonal
allergic rhinitis symptoms in children aged 6–11 years.7

 

Conclusion

 AD and AR are common
clinical conditions that affect the quality of life of children. Second
generation antihistamines provide significant advantages like less sedation and
anticholinergic effects that is lacking in the first generation agents. This results
in less disruption of daily activities and interference with school performance.
Fexofenadine, a second generation antihistamine, have shown its effectiveness
in providing relief from the symptoms of AD and AR.