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The time course and duration of cutaneous weal and flare inhibition are often used as surrogate measures of clinical efficacy. Pharmacodynamic differences among antihistamines are often interpreted to indicate differences in clinical efficacy. A systematic review of literature from 1980 to 2006 regarding the histamine induced weal and flare was undertaken. Search terms included \u2018histamine\u2019, \u2018skin test\u2019, \u2018weal\u2019, \u2018flare\u2019, and \u2018antihistamine\u2019; retrieved articles were searched for relevant studies not identified initially. Data from human studies on the inhibition of the weal and flare by second\u2010generation antihistamines were extracted and assessed. A literature search from 1980 to 2006 was undertaken for comparative studies of second\u2010generation antihistamines in the clinical settings of allergic rhinitis (AR) and chronic idiopathic urticaria; data extracted from these studies underwent systematic review. Differences were noted among second\u2010generation antihistamines in terms of their ability to inhibit the histamine\u2010induced weal and flare. Corresponding differences in terms of clinical efficacy in AR and chronic urticaria were not identified following a systematic review. The reasons for the disconnect between pharmacodynamic effects and clinical efficacy may include differences between the route and concentration of histamine, the involvement of mediators other than histamine in the allergic response, and the short time course of pharmacodynamic studies. The histamine\u2010induced weal and flare response is a pharmacodynamic test that should not be used to compare the clinical efficacy of different antihistamines, and is not an adequate alternative to clinical end\u2010point assessments in AR or chronic idiopathic urticaria.<\/jats:p>","DOI":"10.1111\/j.1365-2222.2007.02662.x","type":"journal-article","created":{"date-parts":[[2007,3,9]],"date-time":"2007-03-09T16:46:30Z","timestamp":1173458790000},"page":"400-414","source":"Crossref","is-referenced-by-count":19,"title":["Inhibition of the histamine\u2010induced weal and flare response: a valid surrogate measure for antihistamine clinical efficacy?"],"prefix":"10.1111","volume":"37","author":[{"given":"P.","family":"Devillier","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Bousquet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2007,3,9]]},"reference":[{"key":"e_1_2_6_2_2","first-page":"291","article-title":"Allergic rhinitis","volume":"28","author":"Salib RJ","year":"2003","journal-title":"past, present and the future"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2005.09.047"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)63155-9"},{"key":"e_1_2_6_5_2","first-page":"1391","article-title":"Quality of life in allergic rhinitis and asthma","volume":"162","author":"Leynaert B","year":"2000","journal-title":"a population-based study of young adults"},{"issue":"41","key":"e_1_2_6_6_2","first-page":"7","article-title":"The impact of allergic rhinitis on quality of life and other airway diseases. 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