Impact of Desloratadine on Symptoms and Quality of Life in Subjects with Chronic Idiopathic Urticaria: A Multicenter, Practice‐based Study

Abstract

BackgroundControlled trials have demonstrated the efficacy of antihistamines in the treatment of chronic idiopathic urticaria. Second-generation antihistamines are recommended as first-line therapy for chronic idiopathic urticaria. The purpose of this study was to determine the effect of desloratadine, a newer, nonsedating, second-generation antihistamine, on symptoms of chronic idiopathic urticaria, disease severity, and quality of life (QoL).MethodsIn an open-label, observational, multicenter study, 348 subjects with chronic idiopathic urticaria were given 5 mg of desloratadine once daily for 2 weeks. Outcome measures included change from baseline at Day 14 using the Aerius Quality of Life Questionnaire (AEQLQ); change from baseline in pruritus score, number and maximum size of hives, sleep quality, and activity impairment; and subjects' response to therapy.ResultsDesloratadine significantly decreased subjects' overall condition and symptom scores from baseline to Day 14 (2.19 ± [SD] 0.66 and 1.14 ± 0.89, respectively; P < 0.0001). Desloratadine treatment significantly improved all 10 AEQLQ domain scores from baseline to Day 7 and Day 14 (P < 0.0001). Sleep disturbance scores decreased 40% from baseline to Day 7 (1.42 ± 1.03 to 0.85 ± 0.89, respectively), and interference with daily outdoor activity scores showed a 41% decrease from baseline to Day 7 (1.11 ± 0.98 to 0.66 ± 0.90) (P < 0.0001 for both). There were significant reductions in itching, size of hives, and hive score at both Days 7 and 14. Treatment resulted in moderate, marked, or complete relief of symptoms in 76.2% of subjects. Desloratadine was well tolerated, with no adverse events reported.ConclusionIn an open-label, observational study, desloratadine 5 mg once daily significantly decreased symptoms of chronic idiopathic urticaria and improved subject QoL.

Clinical effectiveness and safety of cetirizine versus rupatadine in chronic spontaneous urticaria: a randomized, double‐blind, 6‐week trial

“…The most common approach to managing chronic urticaria is to prevent the release of histamine or to block its effects at receptor sites on nerves and endothelial cells. Therefore, non‐sedating H 1 ‐antihistamines represent the keystone of urticaria treatment . Treating the symptoms of CsU and ensuring a decent quality of life in patients is challenging to physicians.…”

“…It has a high H 1 receptor-binding affinity, which allows the molecule to inhibit histamine-induced interleukin-6 and interleukin-8 production using concentrations that are below plasma levels at the therapeutic dose. 11,22 Although the present study used a small sample size and was of short duration, the value of its results cannot be ignored. However, studies with larger sample sizes and longer follow-up periods, along with measurements of absolute eosinophil counts, may yield more meaningful data to compare rupatadine with cetirizine.…”

“…Rupatadine, in addition, has anti‐inflammatory effects that act directly on H 1 receptors. It has a high H 1 receptor‐binding affinity, which allows the molecule to inhibit histamine‐induced interleukin‐6 and interleukin‐8 production using concentrations that are below plasma levels at the therapeutic dose …”

“…Therefore, non-sedating H 1 -antihistamines represent the keystone of urticaria treatment. 11 Treating the symptoms of CsU and ensuring a decent quality of life in patients is challenging to physicians. Our in-depth search and review of the literature failed to retrieve any data comparing the efficacy and safety of recently developed non-sedating antihistamines or of the PAF antagonist rupatadine with the wellestablished H 1 -antihistamine cetirizine.…”

Rupatadine: efficacy and safety of a non-sedating antihistamine with PAF-antagonist effects

“…By day 28, rupatadine had produced a marked improvement in clinical status and symptom score compared with initial values. The rupatadine group showed a reduction in serum IgE of 15.3% (p = 0.024), a drop in total symptom score of 28.2% (p = 0.02) and a reduction in the specific quality of life questionnaire score of 27.3 % [ 43 ]. The overall efficacy score for rupatadine was significantly higher (p = 0.009) compared to levocetirizine.…”