BACKGROUND:Patients with acquired cold urticaria (ACU) show itchy wheals during cold exposure. This disturbing condition involves histamine and platelet-activating factor in its pathogenesis. Rupatadine is a dual antagonist of both histamine and platelet-activating factor. OBJECTIVE: To assess rupatadine efficacy in preventing reactions to cold challenge in patients with ACU. METHODS: A crossover, randomized, double-blind, placebo-controlled study in which 21 patients with ACU receivedrupatadine, 20 mg/d, or placebo for 1 week each is presented. The main outcome was the critical stimulation time threshold (CSTT) determined by ice cube challenge. Secondary outcomes included CSTT and the critical temperature threshold assessed by a cold provocation device (TempTest 3.0), as well as scores for wheal reactions, pruritus, burning sensations, and subjective complaints after cold challenge. RESULTS: After rupatadine treatment, 11 (52%) of 21 patients exhibited a complete response (ie, no urticaria lesions after ice cube provocation). A significant improvement in CSTT compared with placebo was observed after ice cube and TempTest 3.0 challenge (P = .03 and P = .004, respectively). A significant reduction of critical temperature threshold (P < .001) and reduced scores for cold provocation-induced wheal reactions (P = .01), pruritus (P = .005), burning sensation (P = .03), and subjective complaints (P = .03) after rupatadine treatment were also found. Mild fatigue (n = 4), somnolence (n = 1), and moderate headache (n = 1) were reported during active treatment. CONCLUSION:Rupatadine, 20 mg/d, shows high efficacy and is well tolerated in the treatment of ACU symptoms.
RCT Entities:
BACKGROUND:Patients with acquired cold urticaria (ACU) show itchy wheals during cold exposure. This disturbing condition involves histamine and platelet-activating factor in its pathogenesis. Rupatadine is a dual antagonist of both histamine and platelet-activating factor. OBJECTIVE: To assess rupatadine efficacy in preventing reactions to cold challenge in patients with ACU. METHODS: A crossover, randomized, double-blind, placebo-controlled study in which 21 patients with ACU received rupatadine, 20 mg/d, or placebo for 1 week each is presented. The main outcome was the critical stimulation time threshold (CSTT) determined by ice cube challenge. Secondary outcomes included CSTT and the critical temperature threshold assessed by a cold provocation device (TempTest 3.0), as well as scores for wheal reactions, pruritus, burning sensations, and subjective complaints after cold challenge. RESULTS: After rupatadine treatment, 11 (52%) of 21 patients exhibited a complete response (ie, no urticaria lesions after ice cube provocation). A significant improvement in CSTT compared with placebo was observed after ice cube and TempTest 3.0 challenge (P = .03 and P = .004, respectively). A significant reduction of critical temperature threshold (P < .001) and reduced scores for cold provocation-induced wheal reactions (P = .01), pruritus (P = .005), burning sensation (P = .03), and subjective complaints (P = .03) after rupatadine treatment were also found. Mild fatigue (n = 4), somnolence (n = 1), and moderate headache (n = 1) were reported during active treatment. CONCLUSION:Rupatadine, 20 mg/d, shows high efficacy and is well tolerated in the treatment of ACU symptoms.
Authors: K Krause; F Degener; S Altrichter; E Ardelean; D Kalogeromitros; M Magerl; M Metz; F Siebenhaar; K Weller; M Maurer Journal: Hautarzt Date: 2010-09 Impact factor: 0.751
Authors: Karsten Weller; Claudia Ziege; Petra Staubach; Knut Brockow; Frank Siebenhaar; Karoline Krause; Sabine Altrichter; Martin K Church; Marcus Maurer Journal: PLoS One Date: 2011-09-01 Impact factor: 3.240
Authors: Mario Sánchez-Borges; Ignacio Ansotegui; Jorge Montero Jimenez; Maria Isabel Rojo; Carlos Serrano; Anahí Yañez Journal: World Allergy Organ J Date: 2014-11-26 Impact factor: 4.084