Effect of a second-generation antihistamine, levocetirizine, on quality of life in school children with atopic dermatitis

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  • Tokuda Reiko
    Institute for Clinical Research, Mie National Hospital Tokuda Family Clinic
  • Nagao Mizuho
    Institute for Clinical Research, Mie National Hospital
  • Fujisawa Takao
    Institute for Clinical Research, Mie National Hospital

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  • 小児アトピー性皮膚炎に対する抗ヒスタミン薬によるQOL改善効果の検証：レボセチリジン塩酸塩を用いて

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There is strong evidence that atopic dermatitis (AD) has a significant impact on quality of life (QOL) of children and QOL may be a reasonable outcome measure. Relentless itching in AD impairs QOL and antihistamines may alleviate the symptom by antagonizing histamine as a pruritogen. We investigated possible efficacy of a new non-sedating anitihistamine, levocetirizine, on QOL of school children with AD. Twenty three children at 7 to 14 years of age who had been uncontrolled with guideline-based standard treatment with topical glucocorticoids, topical calcineurin inhibitors, and moisturizing agents were enrolled in the study. Levocetirizine at 2.5 mg was administered twice daily for 4 weeks and the Children's Dermatology Life Quality Index (CDLQI) was evaluated before, at 2 and 4 weeks after treatment. The patients recorded their perception of itching during day and night in "itching diary" and severity of AD was evaluated with SCORAD index. Levocetirizine treatment resulted in significant improvement in total score of CDQLI as well as SCORAD score and diary-recorded itching score. In CDQLI, domains of itching, sleep quality, negative emotions and treatment burden were significantly improved by the treatment. There was a significant correlation between CDQLI and SCORAD scores (Spearman' correlation coefficient of 0.43) indicating the QOL measure well represents severity of AD. These results suggest that levocetirizine may be useful as a second line treatment for children with AD and that CDQLI may be a good outcome measure in clinical studies of AD.<br>

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