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ORIGINAL ARTICLE
Year : 2000  |  Volume : 66  |  Issue : 6  |  Page : 301-303

A Study of the Therapeutic Efficacy of Various Regimes in Chronic Urticaria




Correspondence Address:
Pratibha Dave


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Source of Support: None, Conflict of Interest: None


PMID: 20877108

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  Abstract 

A total of sixty patients with chronic urticaria (>3 months duration) were divided into three groups. Group A - was treated once daily with tab loratadine 10 mg. Group B- with cetrizine 10 mg and Group C - with tab fexofenadine hydrochloride 180 mg. Total duration of treatment was 4 weeks. Pre and Post treatment evaluation were made. It was observed that loratadine was superior to all, cetrizine was second and fexofenadine was third regarding over all clinical efficacy, while side effects like sedation was maximum observed in nine cases, with cetrizine, No side effects were observed with the other two regimens.


Keywords: Urticaria, Cetirizine, Loratadine, Fexofenadine hydrochloride


How to cite this article:
Dave P, Pedhiar B, Kari. A Study of the Therapeutic Efficacy of Various Regimes in Chronic Urticaria. Indian J Dermatol Venereol Leprol 2000;66:301-3

How to cite this URL:
Dave P, Pedhiar B, Kari. A Study of the Therapeutic Efficacy of Various Regimes in Chronic Urticaria. Indian J Dermatol Venereol Leprol [serial online] 2000 [cited 2020 Jun 4];66:301-3. Available from: http://www.ijdvl.com/text.asp?2000/66/6/301/4953



  Introduction Top


Chronic urticaria is characterized by recurrent urticarial weals, and episodes last for more than six to eight weeks. Patients are always in search of a permanent cure. Usually H1 receptors mediate the pruritic, vasodilatory and vasopermeable action of histamine in urticaria. The first generation H1 antagonist apart from their specific H1 receptor inhibitory effects, may produce sedation and constipation like side effects.

The commercially available newer antihistamines like loratadine, cetrizine and fexofenadine have selective action on peripheral H1 receptors and almost negligible affinity for other receptors and are poorly soluble in lipid, so sedative effects and the additive effects with alcohol are also reduced.[1]

To evaluate the therapeutic efficacy and side effects of the newer group of antihistamines, all the three group of drugs were selected for the trial in chronic urticaria.


  Materials and methods Top


Sixty patients in the group of 12-60 years were selected from Civil Hospital, out patient Department of Dermatology. Patients with minimum three months of duration of urticaria were selected. Pregnant women, nursing mothers and women using birth control pills and children below 12 years were excluded from the study.

Detailed history was elicited regarding drugs taken for any other illness, hay fever, chronic rhinitis and for any septic focus or chronic infection. Complete blood chemistry, urine, stool, liver function tests were done before selection for the trial.

Patients were instructed to stop all the previous medication at least one week preceding the trial. A general and systemic examination was conducted and their consents, were obtained at the initial visit. All patients were divided into three groups, Group-A, Group-B and Group-C.

Group-A was given tablet loratadine 10mg once daily

Group-B was given tablet cetrizine 10 mg- once daily

Group-C was given tablet fexofenadine hydrochloride 180 mg- once daily

The above regimen was given for a duration of four weeks. The results were evaluated according to evaluation criteria [Table - 1] and analysed. Side effects were observed and noted at the end of study.


  Results Top


As shown in [Table - 1] the patients of each group were analysed every week with objective and subjective evaluation score.

At the end 04 weeks, group -A (loratadine) showed excellent response in patients, one patient showed good response and another had better response while group-B (cetrizine) showed excellent response in nine patients, three had good response and eight had better response, group-C (fexofenadine) had excellent response in three patients, good response in six, better response in six and no response in five patients. [Figure - 1]

Loratadine was superior in getting relief from symptoms and signs. Incidence of side effects was also noted and is shown in [Table - 2]. The cetrizine group had maximum side effects like sedation (nine patients) and three patients complained of dryness of mouth alone, while loratadine group and fexofenadine group did not show any side effects.


  Discussion Top


This study showed that loratadine had superior action than cetrizine and fexofenadine group.

Adverse effects were not observed in loratadine as well as fexofenadine group.

Results were comparable with the study of Thomas et al, in which two groups were selected in a trial with loratadine versus cetrizine which loratidine showed superior results. Marchesi et al,[4] had also done a trial with the above two groups which showed better response with loratadine. In both the above trials also, side effects like sedation, was more observed in the cetrizine group.

Fexofenadine hydrochloride is a new, nonsedating long acting antihistamine with highly selective peripheral H1 receptor antogonist activity and 180 mg once daily dose showed optimum effects in chronic urticaria.[5] So it was also included in the present study. It was observed that fexofenadine showed less response than the other two groups. No side effects like sedation or palpitation was observed in this group.

 
  References Top

1.Greaves MV. Chronic urticaria. N Engl J Med 1995; 332: 1767-1772.  Back to cited text no. 1    
2.Passalacqua G, Bousquet J, Bachert C, et al. The clinical safety of H1 receptor antagonists An EAACI position paper. Allergy 1996; 51:666-675.  Back to cited text no. 2    
3.Thomas J, Pandhi RR, Oberoi C, et al. Loratadine versus Cetirizine in urticaria. Indian J Dermatol Venereol Leprol 1998; 64:12-15.  Back to cited text no. 3    
4.Marchesi E, et al. Loratadine and Cetirizine in the treatment of chronic urticaria. Euro J Annual Dermatol Venereol 1994: 3: 148-152  Back to cited text no. 4    
5.Paul E, Berth Jones J, Ortonne JP, et al. Fexofenadine hydrochloride in the treatment of chronic idiopathic urticaria: a placebo controlled parallel group, close ranging study. J Dermatol Treatment 1998: 9: 143-149.  Back to cited text no. 5    


Figures

[Figure - 1]

Tables

[Table - 1], [Table - 2]



 

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