engleski

Cyclosporine in chronic idiopathic urticaria

The treatment of chronic idiopathic urticaria (CIU) is very difficult. According Vena GA et al., cyclosporine (CsA) at a dosage of 5 mg/kg per day progressively reduced to 3 mg/kg per day in addition to background therapy with cetirizine during 8 weeks may be useful in the management of CIU. This multicenter study included 99 population recruited subjects in 18 Italian outpatient clinics, all of them adult patients suffering from several relapsing CIU episodes. Exclusion criteria were other concomitant forms of urticaria, any contraindication to cetirizine and CsA (Sandimum Neoral) and relevant systemic disorders. A a 1- week run-in period with cetirizine, 10 mg/day, the patients entered a 16-week double-blind period of randomized treatment in addition to the background cetirizine therapy and were randomly allocated to one of three treatments: CsA for 16 weeks ; CsA for 8 weeks followed by placebo for 8 weeks (8-week CsA), or placebo for 16 weeks. Sixty (60%) patients reported adverse events with fever in the placebo group (elevated serum creatinine increased in six patients receiving CsA). The Subject’s Global Assessment of relief of symptoms and Dermatology Life Quality Index (DLQI) over 24-week post-randomization period proved the efficacy and point change in total score at 16 and 24 weeks. After 8 weeks, the severity score was significantly improved by CsA with relief of symptoms nd improvement in DLQI scores with CsA compared with placebo (1). This study confirmed the clinical outcome in CIU with CsA as efficient therapy at 8 weeks, as also reported by Grattan et al. (2), Cassano et al. (3), Poon et al. (4), Thompson et al. (5), and Lennox and Leahy (6).

chronic idiopathic urticaria ; treatment

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