TY - JOUR AU - Tran Thi, Huyen AU - Thi, Lan Pham AU - Nguyen Van, Thuong AU - Thi Minh, Phuong Pham AU - Nguyen Trong, Hao AU - Chau Van, Tro AU - Nguyen Huu, Sau AU - Trinh Minh, Trang AU - Dinh Huu, Nghi AU - Hoang Van, Tam AU - Cam, Van Tran AU - Le Huyen, My AU - Tran Hau, Khang AU - Thanh, Thuy Nguyen AU - Thi, Phuong Hoang AU - Thuy, Linh Nguyen AU - Gandolfi, Marco AU - Satolli, Francesca AU - Feliciani, Claudio AU - Tirant, Michael AU - Vojvodic, Aleksandra AU - Lotti, Torello PY - 2019/01/28 Y2 - 2024/03/28 TI - The Efficacy of a Two-Fold Increase of H1-Antihistamine in the Treatment of Chronic Urticaria - the Vietnamese Experience JF - Open Access Macedonian Journal of Medical Sciences JA - Open Access Maced J Med Sci VL - 7 IS - 2 SE - B - Clinical Sciences DO - 10.3889/oamjms.2019.069 UR - https://oamjms.eu/index.php/mjms/article/view SP - 259-263 AB - <p><strong>BACKGROUND: </strong>Chronic urticaria, a mast cell-driven condition, is common, debilitating and hard to treat. H1-antihistamines are the first line treatment of chronic urticaria, but often patients do not get satisfactory relief with the recommended dose. European guidelines recommend increased antihistamine doses up to four-fold.</p><p><strong>AIM: </strong>We conducted this study to evaluate the efficacy of increased H1-antihistamine doses up to two-fold in Vietnamese chronic urticaria patients.</p><p><strong>METHODS: </strong>One hundred and two patients with chronic urticaria were recruited for treatment with levocetirizine (n = 52) or fexofenadine (n = 50). Treatment started at the conventional daily dose of 5 mg levocetirizine or 180 mg fexofenadine for 2 weeks and then increased to 10 mg levocetirizine or 360 mg fexofenadine for 2 weeks if patients did not have an improvement in symptoms. At week 0, week 2 and week 4 wheal, pruritus, size of the wheal, total symptom scores, and associated side-effects were assessed.</p><p><strong>RESULTS: </strong>With the conventional dose, the total symptom scores after week 2 decreased significantly in both groups compared to baseline figures, i.e. 7.4 vs 2.3 for levocetirizine group and 8.0 vs 2.6 for fexofenadine group (p &lt; 0.05). However, there were still 26 patients in each group who did not have improvements. Of these 26 patients, after having a two-fold increase of the conventional dose, 11.5% and 38.5% became symptom-free at week 4 in levocetirizine group and fexofenadine group, respectively. At week 4 in both groups, the total symptom scores had significantly decreased when compared with those at week 2 (2.8 ± 1.5 versus 4.7 ± 1.6 in levocetirizine group; 2.1 ± 1.9 versus 5.1 ± 1.4 in fexofenadine group). In both groups, there was no difference in the rate of negative side effects between the conventional dose and the double dose.</p><p><strong>CONCLUSION: </strong>This study showed that increasing the dosages of levocetirizine and fexofenadine by two-fold improved chronic urticaria symptoms without increasing the rate of negative side effects.</p> ER -