Abstract
Objective: Antihistamines are among the most prescribed medicines in
otorhinolaryngology. This drug is excellent for rhinorrhea, sneezing and
itching, however, it has a debatable effect in rhinosinusitis. At this
point, it is useful to examine the relationship between antihistamine
and the incidence of sinusitis based on large-cohort data analysis.
Design: Retrospective study Setting: A Nationwide cohort study which
used population-based insurance data (consisting of data from
approximately 1 million patients). Participants: The antihistamine (AH)
group consisted of patients who were diagnosed with allergic rhinitis
(AR) between January 1, 2003 and December 31, 2003, taking at least one
dose of antihistamine. Non-antihistamine (non-AH) group of patients who
did not take antihistamines was obtained by 1:4 propensity score
matching. Main outcome measures: Primary endpoint was the occurrence of
sinusitis. Results: The adjusted hazard ratio for the sinusitis in the
AH group was 1.53 [95% CI: 1.36-1.72] compared with the non-AH
group. Sinusitis was more frequent in women (HR: 1.34), and less
frequent the older the age (HR: 0.74, 0.58, 0.46, respectively) after
exposure to antihistamine. In the subgroup analysis regarding the AH
usage duration, there was no significant difference between the four
subgroups. Conclusion: Antihistamines are probably the most prescribed
medicines in the rhinologic area. But as all things have advantages and
disadvantages, this large-scale longitudinal study shows that
antihistamines are closely associated with sinusitis regardless of
prescription duration and thus should be cautiously prescribed.