The Efficacy of a Two-Fold Increase of H1-Antihistamine in the Treatment of Chronic Urticaria - the Vietnamese Experience
| Autor: | Trang Trinh Minh, Phuong Pham Thi Minh, Phuong Hoang Thi, Michael Tirant, Lan Pham Thi, Thuy Nguyen Thanh, Khang Tran Hau, Huyen Tran Thi, Nghi Dinh Huu, Tro Chau Van, Aleksandra Vojvodic, Hao Nguyen Trong, Linh Nguyen Thuy, Tam Hoang Van, Thuong Nguyen Van, Van Tran Cam, Francesca Satolli, My Le Huyen, Claudio Feliciani, Marco Gandolfi, Torello Lotti, Sau Nguyen Huu |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Levocetirizine Dose medicine.medical_treatment lcsh:Medicine 030209 endocrinology & metabolism Fexofenadine Gastroenterology Antihistamine 03 medical and health sciences 0302 clinical medicine Internal medicine medicine 030212 general & internal medicine H1 antihistamine Chronic urticaria Double dose business.industry lcsh:R General Medicine Clinical Science First line treatment Chronic idiopathic urticaria business medicine.drug |
| Zdroj: | Open Access Macedonian Journal of Medical Sciences Open Access Macedonian Journal of Medical Sciences, Vol 7, Iss 2 (2019) Open Access Macedonian Journal of Medical Sciences; Vol 7 No 2 (2019): Jan 30 (OAMJMS) Vietnamese Dermatology; 259-263 |
| ISSN: | 1857-9655 |
| DOI: | 10.3889/oamjms.2019.069 |
| Popis: | BACKGROUND: Chronic urticaria, a mast cell-driven condition, is common, debilitating and hard to treat. H1-antihistamines are the first line treatment of chronic urticaria, but often patients do not get satisfactory relief with the recommended dose. European guidelines recommend increased antihistamine doses up to four-fold. AIM: We conducted this study to evaluate the efficacy of increased H1-antihistamine doses up to two-fold in Vietnamese chronic urticaria patients. METHODS: One hundred and two patients with chronic urticaria were recruited for treatment with levocetirizine (n = 52) or fexofenadine (n = 50). Treatment started at the conventional daily dose of 5 mg levocetirizine or 180 mg fexofenadine for 2 weeks and then increased to 10 mg levocetirizine or 360 mg fexofenadine for 2 weeks if patients did not have an improvement in symptoms. At week 0, week 2 and week 4 wheal, pruritus, size of the wheal, total symptom scores, and associated side-effects were assessed. RESULTS: With the conventional dose, the total symptom scores after week 2 decreased significantly in both groups compared to baseline figures, i.e. 7.4 vs 2.3 for levocetirizine group and 8.0 vs 2.6 for fexofenadine group (p < 0.05). However, there were still 26 patients in each group who did not have improvements. Of these 26 patients, after having a two-fold increase of the conventional dose, 11.5% and 38.5% became symptom-free at week 4 in levocetirizine group and fexofenadine group, respectively. At week 4 in both groups, the total symptom scores had significantly decreased when compared with those at week 2 (2.8 ± 1.5 versus 4.7 ± 1.6 in levocetirizine group; 2.1 ± 1.9 versus 5.1 ± 1.4 in fexofenadine group). In both groups, there was no difference in the rate of negative side effects between the conventional dose and the double dose. CONCLUSION: This study showed that increasing the dosages of levocetirizine and fexofenadine by two-fold improved chronic urticaria symptoms without increasing the rate of negative side effects. |
| Databáze: | OpenAIRE |
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