Non sedating antihistamines urticaria treatment
CSU is a fluctuating disease and the severity of symptoms can change markedly from day to day.This may be one of the reasons why, in routine daily practice, many patients tend to perform on-demand, rather than continuous, daily, preventive treatment of their symptoms with H-antihistamines.You can contact the Webmaster if would like assistance with this matter.-antihistamines are the recommended first-line treatment for chronic spontaneous urticaria.While efficacy studies usually apply continuous daily treatment regimens, many patients take their medication on demand.In this randomized, double-blind trial we tested whether on-demand H-antihistamine desloratadine in standard and higher doses is able to improve the resolution of existing wheals.Symptoms of 29 patients with chronic spontaneous urticaria were followed without treatment on one day and again on another day during the next 3 weeks after a single dose of either 5 mg or 20 mg desloratadine, using different objective measures.While the intervention with both doses of desloratadine was effective in terms of a reduction in hyperthermic skin area, there was no improvement in wheal area and wheal volume compared with no treatment.
Exclusion criteria were: presence of acute urticaria/acute angioedema, intake of corticosteroids or other immunosuppressive therapy within 14 days prior to the beginning of the study, use of depot corticosteroids or chronic systemic corticosteroids within 21 days prior to the beginning of the study, presence of permanent severe diseases (especially those affecting the immune system), presence of galactose intolerance, lapp lactase deficiency or glucose galactose malabsorption, history of adverse reactions including hypersensitivity to desloratadine or loratadine, and intake of medication that could cause changes in QT interval (drugs listed on
In allergic rhinitis, several studies point towards a better efficacy of modern non-sedating antihistamines if given continuously (8–10).
The only study in CSU examining both treatment approaches was published by Grob and colleagues (11), who showed that daily treatment with desloratadine resulted in significantly better quality of life compared with on-demand therapy.
While these studies indicate that the treatment schedule can generally have a major impact on the outcome of treatment, the results on the efficacy of on-demand ns AHs in CSU have not yet been independently confirmed.
In addition, it has not been studied whether on-demand ns AHs in higher than standard doses might have a beneficial effect compared with standard doses.