Clinical practice guideline for the rational use of oral H<sub>1</sub>-antihistamines in children (2022 edition)_Chinese Journal of Evidence-Based Medicine

Authors：

ZHOU Pengxiang ^1,2 , ZHOU Wei ³ , SHEN Kunling ⁴ , HONG Jianguo ⁵ , ZHAN Siyan ⁶ ,  ZHAI Suodi ^1,2 ,  ZHAO Jing ⁷ ,  WANG Lianglu ⁸ , on behalf of Chinese Society of Allergy, Committee on Pediatrics of China Medicine Education Association, Committee on Pharmacy Administration of China Maternal and Child Health Association, Pediatric Allergy, Immunology and Rheumatology Branch of Asia-Pacific Association of Medicine and Bio-immunology

1. Department of Pharmacy, Peking University Third Hospital, Beijing 100191, P. R. China;
2. Institute for Drug Evaluation, Peking University Health Science Center, Beijing 100191, P. R. China;
3. Department of Pediatrics, Peking University Third Hospital, Beijing 100191, P. R. China;
4. National Center for Children’s Health, Department of Respiratory, Beijing Children’s Hospital, Capital Medical University, National Clinical Research Center for Respiratory Disease, Beijing 100045, P. R. China;
5. Department of Pediatrics, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai 200080, P. R. China;
6. Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, P. R. China;
7. Department of Allergy, Children’s Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, P. R. China;
8. Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, P. R. China;

Corresponding author：

ZHAI Suodi, Email: zhaisuodi@163.com; ZHAO Jing, Email: janezhao0607@163.com; WANG Lianglu, Email: wanglianglu@sina.com

Keywords：

H₁-antihistamine; Children; Allergic disease; Clinical practice guideline

DOI：

10.7507/1672-2531.202205014

Video：

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Abstract Full text Figures/Tables Video References Cited by

Oral H₁-antihistamines are one of the most commonly prescribed drug categories in the treatment of allergic diseases in children. However, its rational application still lacks sufficient evidence and pharmaceutical guidance, making its clinical use risky. Based on the best available evidence, expert experience, and the willingness of patients' families, the guideline development panel developed this guideline, using the grading of recommendations assessment, development and evaluation (GRADE) approach. The guidelines developed 19 recommendations in 8 domains, covering the therapeutic status of oral H₁-antihistamines in pediatric allergic diseases, age range, dose, duration of treatment, adjustment in the presence of hepatic and renal insufficiency, drug interactions, adverse effects and adherence. As a result, this guideline helped to standardize and guide the rational use of oral H₁-antihistamines in pediatric allergic diseases.

Citation： ZHOU Pengxiang, ZHOU Wei, SHEN Kunling, HONG Jianguo, ZHAN Siyan, ZHAI Suodi, ZHAO Jing, WANG Lianglu, on behalf of Chinese Society of Allergy, Committee on Pediatrics of China Medicine Education Association, Committee on Pharmacy Administration of China Maternal and Child Health Association, Pediatric Allergy, Immunology and Rheumatology Branch of Asia-Pacific Association of Medicine and Bio-immunology. Clinical practice guideline for the rational use of oral H₁-antihistamines in children (2022 edition). Chinese Journal of Evidence-Based Medicine, 2022, 22(12): 1365-1374. doi: 10.7507/1672-2531.202205014 Copy

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2. Wong GWK, Li J, Bao YX, et al. Pediatric allergy and immunology in China. Pediatr Allergy Immunol, 2018, 29(2): 127-132.
3. Asher MI, Montefort S, Björkstén B, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet, 2006, 368(9537): 733-743.
4. 王云, 刘虎. 儿童过敏性结膜炎流行病学特征及相关因素研究进展. 南京医科大学学报(自然科学版), 2021, 41(8): 1252-1257.
5. Brüske I, Standl M, Weidinger S, et al. Epidemiology of urticaria in infants and young children in Germany-results from the German LISAplus and GINIplus Birth Cohort Studies. Pediatr Allergy Immunol, 2014, 25(1): 36-42.
6. 刘传合, 洪建国, 尚云晓, 等. 中国16城市儿童哮喘患病率20年对比研究. 中国实用儿科杂志, 2015, 30(8): 596-600.
7. Silverberg JI, Barbarot S, Gadkari A, et al. Atopic dermatitis in the pediatric population: a cross-sectional, international epidemiologic study. Ann Allergy Asthma Immunol, 2021, 126(4): 417-428.
8. Odhiambo JA, Williams HC, Clayton TO, et al. Global variations in prevalence of eczema symptoms in children from ISAAC Phase Three. J Allergy Clin Immunol, 2009, 124(6): 1251-1258.
9. Prescott SL, Pawankar R, Allen KJ, et al. A global survey of changing patterns of food allergy burden in children. World Allergy Organ J, 2013, 6(1): 21.
10. Kowalski ML, Ansotegui I, Aberer W, et al. Risk and safety requirements for diagnostic and therapeutic procedures in allergology: World Allergy Organization Statement. World Allergy Organ J, 2016, 9(1): 33.
11. Kumar R, Seibold MA, Burchard EG. Atopic dermatitis, race, and genetics. J Allergy Clin Immunol, 2020, 145(1): 108-110.
12. 中华儿科杂志编辑委员会, 中华医学会儿科学分会. 儿童过敏性疾病诊断及治疗专家共识. 中华儿科杂志, 2019, 57(3): 164-171.
13. Blaiss MS, Hammerby E, Robinson S, et al. The burden of allergic rhinitis and allergic rhinoconjunctivitis on adolescents: a literature review. Ann Allergy Asthma Immunol, 2018, 121(1): 43-52.
14. Metz M, Wahn U, Gieler U, et al. Chronic pruritus associated with dermatologic disease in infancy and childhood: update from an interdisciplinary group of dermatologists and pediatricians. Pediatr Allergy Immunol, 2013, 24(6): 527-539.
15. Stróżek J, Samoliński BK, Kłak A, et al. The indirect costs of allergic diseases. Int J Occup Med Environ Health, 2019, 32(3): 281-290.
16. Tatarkiewicz J, Rzodkiewicz P, Żochowska M, et al. New antihistamines - perspectives in the treatment of some allergic and inflammatory disorders. Arch Med Sci, 2019, 15(2): 537-553.
17. Simons FE. Advances in H1-antihistamines. N Engl J Med, 2004, 351(21): 2203-2217.
18. Del Cuvillo A, Sastre J, Montoro J, et al. Use of antihistamines in pediatrics. J Investig Allergol Clin Immunol, 2007, 17(Suppl 2): 28-40.
19. Fitzsimons R, van der Poel LA, Thornhill W, et al. Antihistamine use in children. Arch Dis Child Educ Pract Ed, 2015, 100(3): 122-131.
20. Parisi GF, Licari A, Papale M, et al. Antihistamines: ABC for the pediatricians. Pediatr Allergy Immunol, 2020, 31(Suppl 24): 34-36.
21. Simons FE, Simons KJ. Histamine and H1-antihistamines: celebrating a century of progress. J Allergy Clin Immunol, 2011, 128(6): 1139-1150.
22. World Health Organization. WHO handbook for guideline development (2nd editon). Available at: https://apps.who.int/iris/handle/10665/145714.
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Clinical practice guideline for the rational use of oral H₁-antihistamines in children (2022 edition)