H1-antihistamines for the treatment of anaphylaxis: Cochrane systematic review


Aziz Sheikh
Professor of Primary Care Research & Development
Allergy & Respiratory Research Group
Division of Community Health Sciences: GP Section
University of Edinburgh
20 West Richmond Street
Edinburgh EH8 9DX


Background:  Anaphylaxis is an acute systemic allergic reaction, which can be life-threatening. H1-antihistamines are commonly used as an adjuvant therapy in the treatment of anaphylaxis. We sought to assess the benefits and harm of H1-antihistamines in the treatment of anaphylaxis.

Methods:  We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library); MEDLINE (1966 to June 2006); EMBASE (1966 to June 2006); CINAHL (1982 to June 2006) and ISI Web of Science (1945 to July 2006). We also contacted pharmaceutical companies and international experts in anaphylaxis in an attempt to locate unpublished material. Randomized and quasi-randomized-controlled trials comparing H1-antihistamines with placebo or no intervention were eligible for inclusion. Two authors independently assessed articles for inclusion.

Results:  We found no studies that satisfied the inclusion criteria.

Conclusions:  Based on this review, we are unable to make any recommendations for clinical practice. Randomized-controlled trials are needed, although these are likely to prove challenging to design and execute.