Atopic dermatitis and skin diseaseThe effectiveness of levocetirizine and desloratadine in up to 4 times conventional doses in difficult-to-treat urticaria
Section snippets
Patients
The 80 patients recruited into the study (27 men and 53 women; age, 19-67 years) had been referred to the tertiary specialist centre of the Clinic of Allergy and Asthma in Sofia with difficult-to-treat chronic urticaria in that they had failed to respond to their previous prescribed treatments (Table I). All had tried standard doses of first-generation and/or second-generation H1-antihistamines, and 58 of the 80 patients, 28 on levocetirizine and 30 on desloratadine, were receiving intermittent
Results
Of the 80 patients randomized to treatment (intention-to-treat population), all 40 patients in the levocetirizine arm completed the study, whereas of the 40 subjects assigned to desloratadine, 3 (2 men and 1 woman) withdrew their informed consent (2 because the study interfered with their professional activities [travelling] while the third chose not to give an explanation about quitting the trial) during the second (2) and third (1) week of treatment. ASST was positive in 47 subjects (59%), 22
Discussion
This study provides evidence that in patients with difficult-to-treat chronic urticaria, increasing the daily dose of 2 second-generation antihistamines, levocetirizine and desloratadine, to up to 4 times their conventionally prescribed doses of 5 mg/d increases the control of urticaria symptoms without compromising patient safety. The number of chronic urticaria patients who became symptom-free more than doubled when administering the drugs in doses double or quadruple the conventional doses.
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Supported by an unrestricted educational grant by UCB Pharma. UCB Pharma had no involvement in the study or the preparation of this article either practically or editorially.
Disclosure of potential conflict of interest: M. K. Church has consulted for FAES Pharma. T. A. Popov has received honoraria from Merck & Co, Schering-Plough, and UCB Pharma and has received research support from Chiesi Pharma, Merck & Co, and UCB Pharma. V. Dimitrov has received honoraria from AstraZeneca, Chiesi Pharma, UCB Pharma and Shering Plough and has received research support from Novartis. The rest of the authors have declared that they have no conflict of interest.