ArticleBritish journal of clinical pharmacology2026
Risk of injury associated with the sedative potential of second-generation antihistamines: A nationwide retrospective cohort study.
Article in British journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Letter to the editor regarding "Risk of injury associated with the sedative potential of second-generation antihistamines: A nationwide retrospective cohort study".British journal of clinical pharmacology · 2026Article
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4 authors.
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Abstract
aimIndividual second-generation antihistamines may possess differential sedative potential due to the variability in central histamine receptor H1 occupancy. This study aimed to evaluate whether the sedative potential of second-generation antihistamines is associated with the risk of injury during Japan's pollen season.
methodsWe conducted a retrospective cohort study using data acquired from a nationwide health insurance claims database in Japan. We enrolled patients with allergic rhinitis who were newly prescribed oral second-generation antihistamines during the pollen season (January-May) between 2006 and 2022. Antihistamines were categorized into two groups based on the estimated central histamine receptor H1 occupancy: ≥ 10% (higher-sedation group: cetirizine, levocetirizine, loratadine, olopatadine and bepotastine) and < 10% (lower-sedation group: fexofenadine, bilastine and desloratadine). The proportions of newly diagnosed injuries during the same pollen season were compared between the higher-sedation and lower-sedation groups using propensity score overlap weighting. Subgroup analysis that stratified patients by age (< 65 and ≥ 65 years) was also conducted.
resultsAmong 1 313 550 eligible patients, 50.2% and 49.8% received higher-sedation and lower-sedation antihistamines, respectively. After overlap weighting, no significant difference in injury risk was observed between the groups (2.6% vs. 2.6%; risk difference, -0.0%; 95% confidence interval, -0.1 to 0.0; P = 0.388). Subgroup analysis showed consistent results across the age groups.
conclusionIn this large nationwide cohort of patients with allergic rhinitis, second-generation antihistamines with higher vs. lower sedative potential showed no difference in injury risk during Japan's pollen season.
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