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

Background Urticaria is a distressing condition associated with diverse clinical presentations. Chronic spontaneous urticaria (CsU) is characterized by wheals and angioedema. Its treatment requires an algorithmic approach to identify the optimum medication. Objectives Cetirizine is commonly used in...

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Bibliographic Details
Published in:International journal of dermatology 2014-05, Vol.53 (5), p.643-649
Main Authors: Dakhale, Ganesh N., Shinde, Abhijit T., Mahatme, Mohini S., Hiware, Sachin K., Mishra, Dharmendra B., Mukhi, Jayesh I., Salve, Anoop M.
Format: Article
Language:English
Subjects:
Adult
Cetirizine - adverse effects
Cetirizine - therapeutic use
Chronic Disease
Cyproheptadine - adverse effects
Cyproheptadine - analogs & derivatives
Cyproheptadine - therapeutic use
Double-Blind Method
Female
Histamine H1 Antagonists, Non-Sedating - adverse effects
Histamine H1 Antagonists, Non-Sedating - therapeutic use
Humans
Male
Prospective Studies
Urticaria - drug therapy
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Summary:Background Urticaria is a distressing condition associated with diverse clinical presentations. Chronic spontaneous urticaria (CsU) is characterized by wheals and angioedema. Its treatment requires an algorithmic approach to identify the optimum medication. Objectives Cetirizine is commonly used in the treatment of urticaria. Rupatadine is a selective non‐sedating H1‐antihistamine approved for the treatment of CsU. This trial was conducted to ascertain whether the properties of rupatadine offer advantages over cetirizine. Methods Seventy patients with CsU were enrolled. Parameters assessed included: (i) mean number of wheals (MNW); (ii) pruritus; (iii) mean total symptom score (MTSS); (iv) size of wheal; (v) interference of wheals with sleep; and (vi) sedation. Patients with CsU were divided randomly into two groups. Routine investigations were performed at baseline and at the end of the study. Results Evaluations of MTSS, MNW, and pruritus revealed statistically significant differences at week 3 compared with baseline in the cetirizine group. However, greater reductions in these parameters were obtained with rupatadine. In patients receiving rupatadine, reductions in the MNW, size of wheals, and intensity of erythema were also significant at six weeks (P 
ISSN:0011-9059
1365-4632
DOI:10.1111/ijd.12250