Related Experiment Video
Updated: Jul 11, 2026
Acupoint Catgut Embedding Therapy in Traditional Chinese Medicine for Managing Allergic Rhinitis
Published on: December 20, 2024
H1-antihistamine treatment in young atopic children: effect on urticaria
1Department of Pediatrics, Canadian Institutes of Health Research National Training Program in Allergy and Asthma, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. lmcniven@hsc.mb.ca
Insights
Long-term levocetirizine treatment effectively prevents and treats urticaria in young atopic children. This study provides evidence for using H1-antihistamines in pediatric populations.
Area of Science:
- Pediatric dermatology
- Allergy and immunology
- Clinical pharmacology
Background:
- Urticaria is a common condition in young children.
- Limited randomized controlled trials exist for pediatric urticaria interventions.
- Atopic dermatitis is prevalent in early childhood.
Purpose of the Study:
- To evaluate the efficacy of long-term levocetirizine in preventing and treating urticaria in atopic toddlers.
- To assess the impact of a second-generation H1-antihistamine on early-onset urticaria.
- To contribute to the evidence base for pediatric urticaria management.
Main Methods:
- A randomized, double-masked, placebo-controlled trial involving 510 atopic children aged 12-24 months.
- Participants received levocetirizine or placebo twice daily for 18 months.
- Caregivers recorded urticaria occurrences, validated by investigators.
Main Results:
- Levocetirizine significantly reduced the incidence of urticaria compared to placebo (27.5% vs 41.6%).
- Children on levocetirizine experienced fewer urticaria episodes (0.71 vs 1.71).
- The duration of urticaria episodes was also shorter with levocetirizine treatment (4.43 vs 5.36 days).
Conclusions:
- Urticaria is a significant early manifestation in atopic children.
- Long-term levocetirizine therapy is effective for pediatric urticaria prevention and treatment.
- Supports the use of non-sedating H1-antihistamines in pediatric allergy management.
Background:
There are few published, randomized, double-masked, placebo-controlled, clinical trials of interventions for urticaria in the pediatric population.
Objective:
To study the effect of long-term treatment with the H1-antihistamine levocetirizine on urticaria in young atopic children.
Methods:
In the randomized, double-masked, parallel-group Early Prevention of Asthma in Atopic Children Study, children with atopic dermatitis aged 12 to 24 months at enrollment received levocetirizine, 0.125 mg/kg, or matching placebo twice daily for 18 months. On a diary card, the child's caregiver recorded the days on which urticaria was observed. This was validated by the study investigator and entered into the electronic case report form, along with any additional relevant information.
Results:
A total of 510 atopic children (mean +/- SEM age, 19.4 +/- 0.2 months) composed the intention-to-treat population. During the subsequent 18 months, 27.5% (70/255) of the children taking levocetirizine and 41.6% (106/255) of the children taking placebo experienced urticaria (P < .001). The mean +/- SEM number of urticaria episodes was 0.71 +/- 0.11 in those receiving levocetirizine and 1.71 +/- 0.25 in those receiving placebo (P < .001). The mean +/- SEM duration of urticaria episodes was 4.43 +/- 1.57 days in those receiving levocetirizine and 5.36 +/- 1.27 days in those receiving placebo (P < .001).
Conclusions:
Urticaria is common in atopic toddlers and deserves recognition as an important disorder that occurs early in the atopic marathon. Regular long-term treatment with levocetirizine effectively prevents and treats urticaria in young children. The results of this study strengthen the evidence base for the use of relatively nonsedating, second-generation H1-antihistamines in the pediatric population.
Related Concept Videos
01:15Upper Respiratory Drugs: First and Second-Generation Antihistamines
Histamine binds to specific receptor sites, known as H1 receptors, on tissue cells, triggering inflammation and swelling. Antihistamines combat these effects by competing with histamine for these receptor sites. By...
01:25Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
01:19Antiasthma Drugs: Leukotriene Modifiers
Leukotriene modifiers work through two distinct mechanisms:
01:28Acid Suppressive Drugs for Peptic Ulcer Disease: Histamine H2-Receptor Antagonists
01:30Allergic Reactions: Anaphylaxis
02:06Allergic Reactions