Efficacy of leukotriene receptor antagonist with an anti-H1 receptor antagonist for treatment of chronic idiopathic urticaria.

Abstract

BACKGROUND:

Chronic idiopathic urticaria (CIU) is often difficult to treat. Although histamine-releasing activity is detectable for up to 50% of CIU patients, antihistamine therapy provides only a limited response.

OBJECTIVE:

This study aimed to assess the clinical efficacy of combined leukotriene receptor antagonist (LRA) and H1 antihistamine, H1 and H2 antihistamine, and two H1 antihistamines as a synergistic therapeutic regimen for treating CIU compared with a matched placebo modality.

METHODS:

A total of 120 newly diagnosed adult patients were evaluated. Patients were single blinded and randomly assigned to one of four medication groups that received the following regimens for 4 weeks: Group A, combination of sedating H1 antihistamine and non-sedating H1 antihistamine; Group B, combination of H1 antihistamine and H2 antihistamine; Group C, combination of H1 antihistamine and LRA; and Group D, matched placebo medication. The primary measure of treatment efficacy was the daily urticaria activity score (UAS) of 'wheal and itch'. A positive therapeutic response was defined as a reduction to < 25% of baseline weekly UAS, while a relapse was a return to > 75% of baseline weekly UAS.

RESULTS:

In all, 107 patients completed the trial medication. At the end of 4 weeks, the UAS score as a response to treatment was 23.3% for Group A, 63.3% for Group B, 53.3% for Group C, and no real change for the placebo treatment group.

CONCLUSIONS:

The combination of LRA and H1 receptor antagonist is promising for CIU treatment and is reasonably well tolerated by patients. The combination of H1- and H2-receptor antagonists provided the greatest treatment efficacy by the measures used in this small study.

• Authors: Kong-Sang Wan
• Journal: The Journal of dermatological treatment (J Dermatolog Treat) Vol. 20 Issue 4 Pg. 194-7 ( 2009) ISSN: 1471-1753 [Electronic] England
• PMID: 19085267 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Acetates
• Cyclopropanes
• Histamine H1 Antagonists
• Histamine H2 Antagonists
• Leukotriene Antagonists
• Quinolines
• Sulfides
• Hydroxyzine
• Famotidine
• montelukast
• Cetirizine

Topics

• Acetates (administration & dosage)
• Adolescent
• Adult
• Cetirizine (administration & dosage)
• Chronic Disease
• Cyclopropanes
• Drug Therapy, Combination
• Famotidine (administration & dosage)
• Female
• Histamine H1 Antagonists (administration & dosage)
• Histamine H2 Antagonists (administration & dosage)
• Humans
• Hydroxyzine (administration & dosage)
• Leukotriene Antagonists (administration & dosage)
• Male
• Middle Aged
• Quinolines (administration & dosage)
• Single-Blind Method
• Sulfides
• Urticaria (drug therapy)
• Young Adult