Managing atopic dermatitis in dogs: are antihistamines as effective as glucocorticoids?

• Main Author: Sarah Long
• Format: Article
• Language: English
• Published: RCVS Knowledge 2020-11-01
• Series: Veterinary Evidence
• Subjects: dog; atopic dermatitis; treatment; antihistamines; glucocorticoids; steroids
• Online Access: https://veterinaryevidence.org/index.php/ve/article/view/335

PICO question In dogs with atopic dermatitis, are antihistamines as effective as glucocorticoids at reducing the severity of clinical signs?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Two randomised control trials and one crossover placebo-controlled trial Strength of evidence Critical appraisal of the selected papers meeting the inclusion criteria collectively provide weak evidence in terms of their experimental design and implementation Outcomes reported The outcomes reported were conflicting. Two studies reported that fexofenadine may be as effective as methylprednisolone at reducing the severity of clinical signs after 6 weeks of treatment however, the study size was small in one and there was limited reporting of the data in the other. The third study, the crossover placebo-controlled trial, tested a variety of antihistamines and prednisone with limited reporting of statistical analysis of the data and found that antihistamines did not provide a sufficient reduction in pruritus unless combined with prednisone Conclusion In view of the strength of evidence and the outcomes from the studies, there is insufficient quality of evidence to answer the PICO question and further comparative study is needed   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.