Effectiveness and safety of antihistamines up to fourfold or higher in treatment of chronic spontaneous urticaria
| Autor: | Heike Röckmann, Anna-Marijke Laheij-de Boer, Ouliana I. Kouznetsova, Imke van den Brink, Alexander S. H. J. Lokin, André C. Knulst, Carla A.F.M. Bruijnzeel-Koomen, Mignon T. van den Elzen, Harmieke van Os-Medendorp, Karin van den Hurk |
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| Rok vydání: | 2017 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Allergy Urticaria Dose medicine.medical_treatment Immunology Pharmacology 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Refractory Internal medicine Journal Article medicine Immunology and Allergy Angioedema business.industry Research Medical record medicine.disease 030228 respiratory system Third line Antihistamines Antihistamine Therapy medicine.symptom business Somnolence |
| Zdroj: | Clinical and Translational Allergy, 7(1). BioMed Central Clinical and Translational Allergy |
| ISSN: | 2045-7022 |
| DOI: | 10.1186/s13601-017-0141-3 |
| Popis: | Background: Treatment with second-generation antihistamines is recommended in patients with chronic spontaneous urticaria (CSU). Some patients remain unresponsive even after up-dosing up to fourfold. Many third line treatment options have limited availability and/or give rise to significant side effects. We investigated effectiveness and safety of antihistamine treatment with dosages up to fourfold and higher. Methods: This retrospective analysis of patients’ records was performed in adult CSU patients suffering wheals and/or angioedema (AE). Demographic, clinical, and therapeutic data was extracted from their medical records. We recorded the type, maximum prescribed dosage, effectiveness, and reported side effects of antihistamine treatment. Results: Of 200 screened patients, 178 were included. Treatment was commenced with a once daily dose of antihistamines. Persisting symptoms meant that up-dosing up to fourfold occurred in 138 (78%) of patients, yielding sufficient response in 41 (23%). Up-dosing antihistamines was necessary in 110 (80%) patient with weals alone or weals with angioedema and 28 (64%) with AE only (p = 0.039). Of the remaining 97 patients with insufficient response, 59 were treated with dosages higher than fourfold (median dosage 8, range 5-12). This was sufficient in 29 patients (49%). Side effects were reported in 36 patients (20%), whereof 30 (17%) experienced somnolence. Side effects after up-dosing higher than fourfold were reported in six out of 59 patients (10%). Conclusion: Up-dosing antihistamines higher than fourfold dosage seems a feasible therapeutic option with regards to effectiveness and safety. The need for third line therapies could be decreased by 49%, with a very limited increase of reported side effects. |
| Databáze: | OpenAIRE |
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