Rupatadine and its effects on symptom control, stimulation time, and temperature thresholds in patients with acquired cold urticaria.

Abstract

BACKGROUND:

Patients with acquired cold urticaria (ACU) show itchy wheals during cold exposure. This disturbing condition involves histamine and platelet-activating factor in its pathogenesis. Rupatadine is a dual antagonist of both histamine and platelet-activating factor.

OBJECTIVE:

To assess rupatadine efficacy in preventing reactions to cold challenge in patients with ACU.

METHODS:

A crossover, randomized, double-blind, placebo-controlled study in which 21 patients with ACU received rupatadine, 20 mg/d, or placebo for 1 week each is presented. The main outcome was the critical stimulation time threshold (CSTT) determined by ice cube challenge. Secondary outcomes included CSTT and the critical temperature threshold assessed by a cold provocation device (TempTest 3.0), as well as scores for wheal reactions, pruritus, burning sensations, and subjective complaints after cold challenge.

RESULTS:

After rupatadine treatment, 11 (52%) of 21 patients exhibited a complete response (ie, no urticaria lesions after ice cube provocation). A significant improvement in CSTT compared with placebo was observed after ice cube and TempTest 3.0 challenge (P = .03 and P = .004, respectively). A significant reduction of critical temperature threshold (P < .001) and reduced scores for cold provocation-induced wheal reactions (P = .01), pruritus (P = .005), burning sensation (P = .03), and subjective complaints (P = .03) after rupatadine treatment were also found. Mild fatigue (n = 4), somnolence (n = 1), and moderate headache (n = 1) were reported during active treatment.

CONCLUSION:

Rupatadine, 20 mg/d, shows high efficacy and is well tolerated in the treatment of ACU symptoms.

• Authors: Martin Metz, Elisabeth Scholz, Marta Ferrán, Iñaki Izquierdo, Ana Giménez-Arnau, Marcus Maurer
• Journal: Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology (Ann Allergy Asthma Immunol) Vol. 104 Issue 1 Pg. 86-92 (Jan 2010) ISSN: 1081-1206 [Print] United States
• PMID: 20143651 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Histamine Antagonists
• Platelet Activating Factor
• rupatadine
• Cyproheptadine

Topics

• Adult
• Cold Temperature
• Cyproheptadine (administration & dosage, adverse effects, analogs & derivatives)
• Double-Blind Method
• Environmental Exposure
• Female
• Histamine Antagonists (administration & dosage, adverse effects)
• Humans
• Male
• Middle Aged
• Platelet Activating Factor (antagonists & inhibitors)
• Pruritus
• Treatment Outcome
• Urticaria (drug therapy, physiopathology)