Treatment of severe chronic idiopathic urticaria with oral mycophenolate mofetil in patients not responding to antihistamines and/or corticosteroids.

Abstract

BACKGROUND:

Urticarial patients are usually treated with oral antihistamines and 50% respond well to this treatment; however, the other 50% do not respond to antihistamines and need a more aggressive approach, such as short or prolonged courses of oral corticosteroids or cyclosporine. Potential adverse effects, however, limit this regimen.

OBJECTIVE:

To determine the efficacy of mycophenolate mofetil, an immunomodulatory drug, in the treatment of patients with severe chronic urticaria.

METHODS:

In an open-label, uncontrolled trial, nine patients with documented chronic urticaria who had been treated previously with antihistamines and/or corticosteroids with poor response were enrolled in the trial. After 2 weeks of baseline assessment, patients received 1000 mg twice daily of mycophenolate mofetil for 12 weeks. Improvement was monitored using the urticarial activity score, which is the sum of the wheal number score and itch severity score. Patients also recorded their daily need for other medications to control allergic symptoms.

RESULTS:

There was a significant decrease in the urticarial activity score relative to the baseline assessment at the end of the study period (P < 0.001). All patients were able to stop prednisone on completion of the study. There was also a decrease in antihistamine dose, but this did not reach statistical significance. Treatment with mycophenolate mofetil was not associated with significant adverse effects.

CONCLUSIONS:

Mycophenolate mofetil may be a valuable and safe treatment for patients with chronic urticaria who do not respond to antihistamines and/or corticosteroids, and who require aggressive treatment to control their disease symptoms. Further controlled clinical studies are needed to determine its value.

• Authors: Eduardo Shahar, Reuven Bergman, Emma Guttman-Yassky, Shimon Pollack
• Journal: International journal of dermatology (Int J Dermatol) Vol. 45 Issue 10 Pg. 1224-7 (Oct 2006) ISSN: 0011-9059 [Print] England
• PMID: 17040448 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Adrenal Cortex Hormones
• Histamine H1 Antagonists
• Immunosuppressive Agents
• Mycophenolic Acid

Topics

• Administration, Oral
• Adolescent
• Adrenal Cortex Hormones (therapeutic use)
• Adult
• Aged
• Female
• Histamine H1 Antagonists (therapeutic use)
• Humans
• Immunosuppressive Agents (administration & dosage)
• Male
• Middle Aged
• Mycophenolic Acid (administration & dosage, analogs & derivatives)
• Severity of Illness Index
• Treatment Failure
• Urticaria (drug therapy)