***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Non-sedating H1-antihistamines are the recommended first-line treatment for chronic spontaneous urticaria . While efficacy studies usually apply continuous daily treatment regimens , many patients take their medication on dem and . In this r and omized , double-blind trial we tested whether on-dem and H1-antihistamine desloratadine in st and ard and higher doses is able to improve the resolution of existing wheals . Symptoms of 29 patients with chronic spontaneous urticaria were followed without treatment on one day and again on another day during the next 3 weeks after a single dose of either 5 mg or 20 mg desloratadine , using different objective measures . While the intervention with both doses of desloratadine was effective in terms of a reduction in hyperthermic skin area , there was no improvement in wheal area and wheal volume compared with no treatment . Wheal numbers were reduced after treatment with 20 mg , but not 5 mg , desloratadine . In conclusion , the beneficial effects of non-sedating H1-anti-histamines given on dem and appear to be low . Thus , a preventive treatment strategy should be preferred in chronic spontaneous urticaria BACKGROUND Mizolastine is a novel histamine H1-antagonist registered in Europe for the management of allergic rhinitis and urticaria . OBJECTIVES To compare the clinical efficacy and safety of mizolastine with loratadine and placebo in patients with chronic idiopathic urticaria ( CIU ) . METHODS A multicentre , double-blind , parallel group study was design ed in which 247 patients with CIU were r and omised after a 1-week placebo run-in period to 10 mg daily mizolastine ( n = 88 ) , 10 mg daily loratadine ( n = 79 ) , or placebo ( n = 80 ) for a 4-week treatment period . RESULTS Mizolastine and loratadine both relieved symptoms of CIU . After 2 weeks ' treatment , the severity of pruritus ( visual analogue score ( VAS ) assessed by patients ) decreased significantly in both the mizolastine and loratadine groups compared with placebo ( mizolastine : -36.7 mm , P = 0.0001 ; loratadine : -29.8 , P = 0.0071 ; placebo : -16.3 ) ; this improvement with both active treatments was maintained throughout the treatment period , the difference being significant only for the mizolastine group ( P = 0.0090 ) . Both active treatments were also associated with reduced weekly episodes of urticaria compared with placebo , which was significant after 2 weeks ' treatment ( mizolastine : 7.9 episodes , P = 0.0061 ; loratadine : 8.3 , P = 0.0221 ; placebo : 13.3 ) . Angioedema was improved to a clinical ly significant extent with mizolastine , and loratadine compared with placebo in those patients who had this symptom before treatment . Overall tolerability of both treatments was similar to placebo , and there were no clinical ly relevant effects on cardiac repolarisation with either mizolastine or loratadine . CONCLUSION Mizolastine ( 10 mg daily ) is confirmed as an effective and well tolerated agent , comparable to loratadine and superior to placebo , for the management of CIU . Mizolastine acted as rapidly as loratadine in improving urticarial symptoms from the first day of treatment The efficacy and safety of a new non-sedating antihistamine , loratadine ( Clarityn , CAS 79794 - 75 - 5 ) 10 mg q.d . , was compared to the classical antihistamine , hydroxyzine 25 mg t.i.d . and placebo in a 4-week ( optional 12 week ) r and omized , double-blind , multi-center study in 203 patients with chronic idiopathic urticaria .  Efficacy evaluations included weekly physician and patient assessment s of pruritus , overall disease condition , and therapeutic response to treatment .  Loratadine and hydroxyzine were significantly more effective than placebo and clinical ly comparable to each other as measured by all efficacy evaluations at each visit . Loratadine was safe and well tolerated with sedation and dry mouth similar to placebo and significantly less than hydroxyzine Background : The long-term follow-up of chronic urticaria ( CU ) is important to ensure the adequate treatment of patients .  Olopatadine hydrochloride is one of the second-generation nonsedating antihistamines . Methods : This study was design ed to assess the optimal dose of olopatadine to suppress symptoms of chronic urticarial itch  in well-controlled patients . After CU patients were treated with 10 mg  olopatadine  , patients having a visual analog scale ( VAS ) itch score of less than 20 were r and omly allocated into one of three groups : 10 mg/day ( n = 35 ) , 5 mg/day ( n = 30 ) , or no medication ( n = 32 ) . Results : The suppressive effects of both the 5 mg and 10 mg olopatadine treatments on the VAS itch score were more significant and longer lasting over a period of 4 weeks than the no-medication treatment . Both the 5-mg group and the 10-mg group showed improved urticarial symptoms and maintained their VAS itch score within normal limits compared to the no-medication group . The differences between the 5-mg and 10-mg groups were not significant . Conclusion : These results demonstrate that treatment with olopatadine at a dose of 5 mg once daily is effective and safe for the management and prevention of CU symptoms for itch in well-controlled patients OBJECTIVE To assess the effect of desloratadine on quality of life ( QoL ) in chronic idiopathic urticaria ( CIU ) . STUDY POPULATION Patients with a history of CIU ( pruritus and weals lasting = 6 weeks ) were included in this multicentre , r and omized , double-blind placebo-controlled study that took place in dermatology centres throughout France . During the study , patients were r and omized to receive desloratadine 5 mg daily or placebo for 42 days . MAIN OUTCOME MEASURES Variation of the scores of two QoL dermatology-specific tools between baseline and day 42 , the French translation version of the Dermatology Life Quality Index ( DLQI ) and the VQ-Dermato ( a French- language scoring instrument ) . RESULTS The intent-to-treat population comprised 137 patients [ desloratadine ( n = 65 ) or placebo ( n = 72 ) ] . Desloratadine treatment was associated with significantly greater improvements from baseline to day 42 compared with placebo in DLQI overall score ( -6 vs. -2.2 points ; P < 0.002 ) and VQ-Dermato score ( 18.5 vs. 29.1 points ; P = 0.009 ) . Mean scores for sleep disruption and disruption of daily activities were significantly lower in the desloratadine group than in the placebo group from day 1 to the end of the study . CONCLUSIONS Desloratadine 5 mg/day was associated with significant improvements in two separate dermatology-specific measures of QoL in patients with CIU .  QoL proved to be a relevant primary outcome measure for therapeutic trials in CIU BACKGROUND Chronic idiopathic urticaria ( CIU ) can have a profound effect on patients ' health and quality of life . OBJECTIVE To evaluate the efficacy and safety of once-daily dosing of fexofenadine hydrochloride , 180 mg , on CIU . METHODS This r and omized , double-blind , parallel-group , placebo-controlled study consisted of a placebo run-in period followed by a 4-week treatment period . Patients 12 years and older with active CIU were r and omized 2:1 to receive once-daily fexofenadine , 180 mg , or placebo . The primary end points were change from baseline in mean daily number of wheals ( MNW score ) and mean daily severity of pruritus during treatment . Secondary efficacy measures included modified total symptom scores and MNW and pruritus severity scores evaluated weekly and instantaneously at trough drug levels . RESULTS Patients administered fexofenadine ( n = 163 ) experienced significantly greater improvements in MNW and pruritus severity scores compared with the placebo group ( n = 92 ) ( P < .001 for both ) . Similarly , throughout treatment and at each individual week , the mean reductions in modified total symptom scores were significantly greater in the fexofenadine group ( P < or = .005 for all comparisons vs placebo ) . The mean reductions in instantaneous MNW and pruritus severity scores were greater in patients in the fexofenadine group than in those who received placebo ( MNW score : P = .015 ; pruritus severity score : P < .001 ) . There were no significant differences in the frequency of treatment-emergent adverse events between the 2 treatment groups . CONCLUSIONS A once-daily dose of fexofenadine hydrochloride , 180 mg , offered effective , well-tolerated relief for the management of CIU Oxatomide was evaluated in a double-blind study of 35 patients with chronic urticaria . For 5 weeks patients received at r and om either 30 mg oxatomide b.i.d . or a placebo . Oxatomide significantly reduced not only the duration of the attacks but also the severity of erythema , lesions and itching . This lower level of suffering was clearly reflected by a diminished need for additional antiallergic medication . The overall response to treatment was rated excellent or good in 72 % of the oxatomide-treated patients against only 23 % of the controls which is a significant difference . Sleepiness was reported in 1 patient of each group Fifty patients with chronic idiopathic urticaria were studied to compare responses to treatment with doxepin ( 10 mg three times a day ) and with diphenhydramine ( 25 mg three times a day ) . All patients had an evaluation that failed to disclose a cause for their disease . Therapeutic response was assessed according to the suppression of symptoms and symptom diary scores of daily itching and frequency , number , size , and duration of hives . Total clearing of the pruritus and urticarial lesions occurred in 43 % of the patients while receiving doxepin and in only 5 % while receiving diphenhydramine ( p less than 0.001 ) . Partial or total control of the pruritus and hives was noted in 74 % of the patients receiving doxepin and in only 10 % of those receiving diphenhydramine ( p less than 0.001 ) . Doxepin induced markedly less sedation ( 22 % ) than diphenhydramine ( 46 % ) ( p less than 0.05 ) . Dermatopathologic categories included ( 1 ) urticaria simplex , ( 2 ) lymphocytic urticaria , and ( 3 ) leukocytoclastic urticaria . Patients with urticaria simplex had a more favorable response to doxepin than the two other groups BACKGROUND Cetirizine and astemizole have been shown to be safe and effective in the treatment of patients with chronic idiopathic urticaria .  Cetirizine brings about clinical benefit more rapidly . OBJECTIVE The purpose of this study was to compare the efficacy of single daily doses of cetirizine and astemizole in relieving the symptoms of  chronic idiopathic urticaria  , with particular emphasis on the commencement of action . METHODS Patients with chronic idiopathic urticaria were r and omly assigned to relieve either 10 mg of cetirizine , 10 mg of astemizole , or placebo for 4 weeks in a multicenter double-blind trial . Patients rated symptom severity each night , and investigators rated symptoms weekly . RESULTS One hundred eighty-seven patients were enrolled in the trial ; 180 were included in the safety analysis and 177 were included in at least one efficacy analysis . Both cetirizine and astemizole were significantly superior to placebo in relieving symptoms of chronic idiopathic urticaria . Both patients ' and investigators ' ratings indicated that cetirizine acted more rapidly . Both active treatments were well tolerated , and the incidence of somnolence did not differ statistically between cetirizine ( 14.5 % ) and astemizole ( 10.3 % ) . CONCLUSION Both cetirizine and astemizole provide effective relief of the symptoms of chronic idiopathic urticaria with similar side-effect profiles . However , clinical benefit occurs significantly more rapidly with cetirizine BACKGROUND Chronic idiopathic urticaria ( CIU ) has a major impact on patient well-being . Antihistamines are the first-line treatment for CIU ; however , some cause sedation . OBJECTIVE Our purpose was to study the efficacy and safety of desloratadine , 5 mg , a new H(1)-receptor antagonist , in patients with moderate to severe CIU . METHODS This study was a r and omized , double-blind , placebo-controlled , parallel-group , multicenter trial of 6 weeks ' duration . RESULTS Compared with placebo , desloratadine significantly improved the total CIU symptom score as well as pruritus , the number of hives , and the size of the largest hive 
    Output:
    
The quality of the evidence was affected by the small number of studies in each comparison and the small sample size for many of the outcomes , prompting us to down grade the quality of evidence for imprecision ( unless stated for each comparison , the quality of the evidence was low).No single H1-antihistamine st and s out as most effective .
Cetirizine at 10 mg once daily in the short term and in the intermediate term was found to be effective in completely suppressing urticaria .
Evidence is limited for desloratadine given at 5 mg once daily in the intermediate term and at 20 mg in the short term .
Levocetirizine at 5 mg in the intermediate but not short term was effective for complete suppression .
Levocetirizine 20 mg was effective in the short term , but 10 mg was not .
No difference in rates of withdrawal due to adverse events was noted between active and placebo groups .