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首页> 外文期刊>Clinical and Translational Allergy >Effectiveness and safety of antihistamines up to fourfold or higher in treatment of chronic spontaneous urticaria
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Effectiveness and safety of antihistamines up to fourfold or higher in treatment of chronic spontaneous urticaria

机译：抗组胺药治疗慢性自发性荨麻疹的有效性和安全性高达四倍或更高

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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.
机译：背景对于慢性自发性荨麻疹（CSU）的患者，建议使用第二代抗组胺药治疗。有些患者甚至在增加剂量达四倍后仍无反应。许多三线治疗选择的可用性有限和/或引起明显的副作用。我们研究了抗组胺药剂量高达四倍或更高的有效性和安全性。方法这项对患者记录的回顾性分析是在患有风吹和/或血管性水肿（AE）的成年CSU患者中进行的。从他们的病历中提取了人口统计学，临床和治疗数据。我们记录了抗组胺药的类型，最大处方剂​​量，有效性和报道的副作用。结果200例筛查患者中，包括178例。用每天一次的抗组胺药开始治疗。持续的症状意味着138位患者（78％）的剂量增加了四倍，而41位患者（23％）产生了足够的反应。 110名（80％）单独进食或血管性水肿的病人和28名（64％）仅使用AE的患者需要增加剂量的抗组胺药（p？=？0.039）。在其余97例反应不充分的患者中，有59例接受了高于4倍剂量的治疗（中位剂量8，范围5-12）。这对于29位患者（49％）是足够的。据报道有36位患者（20％）出现副作用，其中30位（17％）出现了嗜睡现象。在59位患者中，有6位（10％）报道了高剂量给药后的副作用超过四倍。结论高于四倍剂量的抗组胺药就有效性和安全性而言似乎是可行的治疗选择。对三线疗法的需求可以减少49％，而所报告的副作用却非常有限。

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