Peer-reviewed article
Fexofenadine: review of safety, efficacy and unmet needs in children with allergic rhinitis
Eli O. Meltzer, Nelson Augusto Rosário Filho, Hugo Van Bever, Luiz Antonio Galvão Lucio ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This is a pharmacological review of fexofenadine, a second-generation antihistamine used to treat allergic rhinitis in children. The document discusses the prevalence of allergic rhinitis, its impact on quality of life, and the safety and efficacy profile of fexofenadine compared to other antihistamines. It notes that clinical trial data in children is limited, particularly in those under 6 years old.
Key points
- Allergic rhinitis is the most common undiagnosed chronic condition in children
- Moderate/severe allergic rhinitis symptoms impair quality of life and cause sleep disruption and school absenteeism
- Untreated allergic rhinitis predisposes children to asthma and other chronic conditions
- Fexofenadine is a non-sedating second-generation antihistamine with a favorable safety profile
- Fewer clinical trials exist in children than adults, particularly for children under 6 years
Limitations
This is a literature review rather than an empirical study, so it does not present original research data or interventional outcomes. The document identifies gaps in evidence rather than providing the clinical trial data needed to evaluate fexofenadine's effectiveness in children.
Abstract
Allergic rhinitis (AR) is the most common undiagnosed chronic condition in children. Moderate/severe AR symptoms significantly impair quality of life, and cause sleep disruption, absenteeism and decreased productivity. Additionally, untreated AR predisposes children to asthma and other chronic conditions. Although intranasal corticosteroids are the most effective pharmacologic treatment for AR, oral antihistamines are often preferred. First-generation antihistamines may be chosen to relieve AR symptoms as they are inexpensive and widely available; however, they cause sedative and cardiovascular negative effects due to poor receptor selectivity. Therefore, second-generation antihistamines were developed to reduce adverse effects while retaining efficacy. There are fewer clinical trials in children than adults, therefore, efficacy and safety data is limited, particularly in children under 6 years, highlighting the need to generate these data in young children with AR. Fexofenadine, a highly selective second-generation antihistamine, effectively alleviates symptoms of AR, is non-sedating due to decreased blood-brain barrier permeability, and is devoid of cardiovascular side effects. Importantly, fexofenadine relieves the ocular symptoms of allergic conjunctivitis, which occur concomitantly with AR, improving quality of life. Overall, fexofenadine displays a favorable safety profile and results in greater treatment satisfaction in children compared with other second-generation antihistamines. This review aimed to evaluate and compare the safety and efficacy of fexofenadine with other available first- and second-generation antihistamines in children with AR.