Management of peripheral vertigo with antihistamines: New options on the horizon
| Autor: | Jonas Dyhrfjeld-Johnsen, Pierre Attali |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Side effect Sedation medicine.medical_treatment Histamine Antagonists Reviews Peripheral vertigo 030226 pharmacology & pharmacy Histamine Agonists 03 medical and health sciences 0302 clinical medicine Vertigo otorhinolaryngologic diseases medicine Animals Humans Pharmacology (medical) Betahistine 030212 general & internal medicine Intensive care medicine Aged Receptors Histamine H4 Pharmacology Vestibular system biology business.industry Behavioural intervention biology.organism_classification Pyrimidines Azetidines Antihistamine sense organs medicine.symptom business medicine.drug |
| Zdroj: | Br J Clin Pharmacol |
| ISSN: | 1365-2125 0306-5251 |
| Popis: | Vertigo is associated with a wide range of vestibular pathologies. It increasingly affects the elderly, with a high cost to society. Solutions include vestibular suppressants and vestibular rehabilitation, which form the mainstay of therapy. Antihistamines represent the largest class of agents used to combat vestibular vertigo symptoms. Agents targeting the H(1) and H(3) receptors have been in clinical use for several decades as single agents. Nonetheless, effective management of vertigo proves elusive as many treatments largely address only associated symptoms, and with questionable efficacy. Additionally, the primary and limiting side effect of sedation is counterproductive to normal functioning and the natural recovery process occurring via central compensation. To address these issues, the timing of administration of betahistine, the mainstay H(3) antihistamine, can be fine‐tuned, while bioavailability is also being improved. Other approaches include antihistamine combination studies, devices, physical therapy and behavioural interventions. Recently demonstrated expression of H(4) receptors in the peripheral vestibular system represents a new potential drug target for treating vestibular disorders. A number of novel selective H(4) antagonists are active in vestibular models in vivo. The preclinical potential of SENS‐111 (Seliforant), an oral first‐in‐class selective H(4) antagonist is the only such molecule to date to be translated into the clinical setting. With an excellent safety profile and notable absence of sedation, encouraging outcomes in an induced vertigo model in healthy volunteers have led to ongoing clinical studies in acute unilateral vestibulopathy, with the hope that H(4) antagonists will offer new effective therapeutic options to patients suffering from vertigo. |
| Databáze: | OpenAIRE |
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