Usefulness of a short course of oral prednisone in antihistamine-resistant chronic urticaria: a retrospective analysis.
نویسندگان
چکیده
BACKGROUND The effectiveness of corticosteroids in antihistamine-resistant chronic urticaria (CU) is widely accepted although large studies on their use in this disease are lacking. OBJECTIVE To assess the proportion of patients with antihistamine-resistant CU that respond to a course of corticosteroids. METHODS We studied 750 adult patients with CU and prescribed a course of oral corticosteroids (starting with prednisone 25 mg/day for 3 days) to those who reported little or partial response to antihistamine treatment. The corticosteroid treatment was considered effective if it resulted in long-term control of the disease with antihistamines only. Patients showing a temporary response were offered a second course of prednisone, at the end of which temporary responders and nonresponders were offered ciclosporin therapy for 3 months. RESULTS A total of 660 patients (88%) (male/female, 194/556) responded to antihistamine treatment. In 40/86 patients (47%), prednisone induced remission of the disease and subsequent control with antihistamines at licensed doses only. Thirty-five patients responded well but relapsed when prednisone doses were tapered or shortly after withdrawal. In all responders, the effect was appreciable as early as the day after the first 25 mg dose. In 8/23 temporary responders, a second course of prednisone induced remission of the disease; the other 15 patients responded well but only temporarily. CONCLUSIONS A single short course of prednisone induced remission in nearly 50% of patients with CU, and a second course induced remission in a further 9%. Less than 15% of patients did not respond at all to this treatment.
منابع مشابه
Acupuncture in the treatment of chronic Urticaria
Background: Urticaria is very common and most of the current treatments are only partially successful. Objective: As the efficacy of acupuncture in the treatment of chronic urticaria has not been studied in Iran, we decided to do this study. Patients and Methods: In a randomized, controlled, double-blind clinical trial, 40 patients with chronic urticaria referred to skin clinics of Isfahan Univ...
متن کاملLevocetirizine and Prednisone Are Not Superior to Levocetirizine Alone for the Treatment of Acute Urticaria: A Randomized Double-Blind Clinical Trial.
STUDY OBJECTIVE We evaluate the efficacy of a 4-day course of prednisone added to antihistamine for the management of acute urticaria in an emergency department (ED). METHODS In this double-blind randomized clinical trial, patients were eligible for inclusion if aged 18 years or older and with acute urticaria of no more than 24 hours' duration. Patients with anaphylaxis or who had received an...
متن کاملEfficacy and safety of sulfasalazine in patients with chronic idiopathic urticaria.
BACKGROUND There are limited data regarding alternative treatments for antihistamine refractory chronic idiopathic urticaria (CIU). Patients with recalcitrant skin disease often cannot gain satisfactory symptom control with standard therapies and may require prolonged courses of oral corticosteroids. There is a lack of information describing the degree and duration of sulfasalazine's efficacy, ...
متن کاملRetreatment with omalizumab results in rapid remission in chronic spontaneous and inducible urticaria.
IMPORTANCE Omalizumab has emerged as a novel and effective treatment option for patients with antihistamine-resistant chronic urticaria. It is unclear whether patients with recurrent urticaria symptoms after discontinuation of omalizumab treatment can benefit from retreatment. OBJECTIVE To assess the response of patients with chronic urticaria who receive omalizumab retreatment. DESIGN, SET...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Journal of investigational allergology & clinical immunology
دوره 20 5 شماره
صفحات -
تاریخ انتشار 2010