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GEMA 2009
 

Effect of Antihistamine Up-Dosing in Chronic Urticaria
 
M Ferrer1, J Sastre2, I Jáuregui3, I Dávila4, J Montoro5, A del Cuvillo6, J Mullol7, J Bartra8, A Valero8
1Department of Allergy. Clínica Universidad de Navarra. Medical School. Pamplona, Spain
2Department of Allergy, Jiménez Díaz Foundation, Madrid, Spain. Biomedical Research Centre Network for Respiratory Diseases (CIBERES)
3Department of Allergy, Basurto Hospital. Bilbao, Spain
4Department of Immunoallergy, Salamanca University Healthcare Complex, Salamanca, Spain
5Allergy Section, Elda General Hospital, Alicante, Spain
6Astarté ENT Centre. Cádiz, Spain
7Rhinology Unit & Smell Clinic, ENT Department. Clinical and Experimental Respiratory Immunoallergy (IDIBAPS). Clinic Hospital. Barcelona, Spain. Biomedical Research Centre Network for Respiratory Diseases (CIBERES)
8Allergy Unit. Department of Pneumology and Respiratory Allergy. Clinic Institute of Thorax (ICT). Clinical and Experimental Respiratory Immunoallergy (IDIBAPS). Clinic Hospital. Barcelona, Spain. Biomedical Research Centre of Respiratory Diseases (CIBERES)

J Investig Allergol Clin Immunol 2011; Vol. 21, Suppl. 3: 34-39
 

 Abstract


Chronic urticaria has an important impact upon patient quality of life, and no treatment has yet been developed capable of effectively controlling the disease. The most recent guidelines recommend the use of non-sedating antihistamines at high doses as second-step therapy before resorting to other treatments. The present review examines the studies published to date on the use of H1 antihistamines at doses higher than those indicated as therapeutic doses in chronic urticaria. Most of the studies report no significant differences among the studied doses – only a tendency towards increased response on elevating the dose.There are no clinically well designed, randomized
double-blind trials comparing efficacy between therapeutic doses and doses higher than those indicated in the corresponding Summary of Product Characteristics. Likewise, there are insufficient data to conduct a meta-analysis and thus classify the degree of evidence of the few available studies, which moreover present contradictory results. At present, the prescription of high-dose H1 antihistamines is based only on experts opinion. However, considering the high safety profile of these drugs, it would be a good option to evaluate their efficacy at high doses, before moving on to other therapeutic steps.

Key words: Chronic urticaria. Antihistamines. Chronic urticaria treatment.