{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T01:56:44Z","timestamp":1782698204550,"version":"3.54.5"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2015,7,6]],"date-time":"2015-07-06T00:00:00Z","timestamp":1436140800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Primary mast cell activation syndromes (<jats:styled-content style=\"fixed-case\">MCAS<\/jats:styled-content>) are a group of disorders presenting with symptoms of mast cell mediator release.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess the effectiveness and safety of orally administered H<jats:sub>1<\/jats:sub>\u2010antihistamines in the treatment of primary <jats:styled-content style=\"fixed-case\">MCAS<\/jats:styled-content> compared with placebo and other pharmacologic treatments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We systematically searched five databases and three trial repositories and contacted an international panel of experts to identify published and unpublished trials.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 36 potentially relevant studies were identified. Of these, five crossover trials, enrolling a total of 71 patients (63 adults), met the eligibility criteria. All five of these studies were judged to be at moderate or high risk of bias. Two studies compared an H<jats:sub>1<\/jats:sub>\u2010antihistamine with placebo, two compared two different H<jats:sub>1<\/jats:sub>\u2010antihistamines, and one study compared H<jats:sub>1<\/jats:sub>\u2010 and H<jats:sub>2<\/jats:sub>\u2010antihistamines with oral cromolyn sodium. Four of the five randomized controlled trials were historic (reported from 1983\u20131993), small (enrolling 8\u201315 patients), and used agents and\/or dosing regimens that are now less commonly used in clinical practice (i.e. azelastine, chlorpheniramine, hydroxyzine, and ketotifen). The fifth trial, which enrolled 33 adults with cutaneous and systemic mastocytosis found 4\u00a0weeks of treatment with the second\u2010generation H<jats:sub>1<\/jats:sub>\u2010antihistamine rupatadine, compared with placebo, resulted in significant improvements in quality of life, symptom control (itching, wheals and flares, flushing, tachycardia, and headache, but not gastrointestinal symptoms), and reduction in itching and whealing after standardized skin provocation to elicit Darier's sign.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is an urgent need for large, well\u2010designed, double\u2010blind, placebo\u2010controlled randomized trials investigating the effectiveness, cost\u2010effectiveness, and safety of second\u2010generation H<jats:sub>1<\/jats:sub>\u2010antihistamines in treatment of primary <jats:styled-content style=\"fixed-case\">MCAS<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/all.12672","type":"journal-article","created":{"date-parts":[[2015,6,19]],"date-time":"2015-06-19T18:06:12Z","timestamp":1434737172000},"page":"1052-1061","source":"Crossref","is-referenced-by-count":32,"title":["H<sub>1<\/sub>\u2010antihistamines for primary mast cell activation syndromes: a systematic review"],"prefix":"10.1111","volume":"70","author":[{"given":"U. B.","family":"Nurmatov","sequence":"first","affiliation":[{"name":"Allergy and Respiratory Research Group Usher Institute of Population Health Sciences and Informatics The University of Edinburgh Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Rhatigan","sequence":"additional","affiliation":[{"name":"Victoria Hospital Kirkcaldy NHS Fife Kirkcaldy Fife UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. E. R.","family":"Simons","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Child Health, and Immunology University of Manitoba Winnipeg MB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Sheikh","sequence":"additional","affiliation":[{"name":"Allergy and Respiratory Research Group Usher Institute of Population Health Sciences and Informatics The University of Edinburgh Edinburgh UK"},{"name":"Division of General Internal Medicine and Primary Care Brigham and Women's Hospital\/Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,7,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000328760"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2010.08.035"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2013.02.008"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12126"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.12318"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2011.04.037"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2010.02.019"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.2165\/11588890-000000000-00000"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-012-0326-8"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12436"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iac.2014.01.012"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2011.09.005"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(85)90454-1"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000249832"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(89)90097-3"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(93)90076-R"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12159"},{"key":"e_1_2_10_19_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0","author":"Higgins JPT","year":"2011"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.06.005"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2012.02812.x"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.2307\/2533446"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12313"}],"container-title":["Allergy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fall.12672","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/all.12672","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T23:13:24Z","timestamp":1696461204000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/all.12672"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,7,6]]},"references-count":24,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2015,9]]}},"alternative-id":["10.1111\/all.12672"],"URL":"https:\/\/doi.org\/10.1111\/all.12672","archive":["Portico"],"relation":{},"ISSN":["0105-4538","1398-9995"],"issn-type":[{"value":"0105-4538","type":"print"},{"value":"1398-9995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,7,6]]}}}