BACKGROUND: Chronic urticaria (CU) is a frequent, difficult clinical problem. When first-line therapy fails, patients are often treated with alternative therapies that either have a poor side effect profile or little evidence to support effectiveness. OBJECTIVE: To describe our low-dose cyclosporine-treated CU population and factors predicting a positive outcome. METHODS: A retrospective chart review was conducted of adult CU patients treated with cyclosporine. Elements of the history, physical examination, diagnostic testing, efficacy, and side effects were extracted for statistical analysis. RESULTS: Chronic urticaria was defined as having urticaria more than 3 days per week for 6 consecutive weeks. Sixty-eight adults with CU who fulfilled the intake criteria and completed a course of cyclosporine were identified. After taking cyclosporine at an average dose of 1.8 ± 1.1 mg/kg, 53 (78%) patients attained complete remission defined as ≤ 1 day of hives per month. Recurrence occurred in only 7 patients; all achieved remission with resumption of cyclosporine. A history of hives (P = .01), shorter duration of urticaria (mean: 55.2 weeks vs 259.63 weeks; P = .03), and positive CU Index (P = .05) predicted a favorable response to cyclosporine. Notably, autologous serum skin testing, prior response to steroids, atopic status, or presence of antithyroid antibodies was not predictive. Male sex and a positive ANA trended toward significance (P = .1). Side effects were generally mild and seen in 35% of patients; all were reversible by dose reduction. CONCLUSION: Cyclosporine is an effective treatment for CU, and a history of hives, shorter duration of disease, and CU index ≥10 predict a successful response.
BACKGROUND:Chronic urticaria (CU) is a frequent, difficult clinical problem. When first-line therapy fails, patients are often treated with alternative therapies that either have a poor side effect profile or little evidence to support effectiveness. OBJECTIVE: To describe our low-dose cyclosporine-treated CU population and factors predicting a positive outcome. METHODS: A retrospective chart review was conducted of adult CUpatients treated with cyclosporine. Elements of the history, physical examination, diagnostic testing, efficacy, and side effects were extracted for statistical analysis. RESULTS:Chronic urticaria was defined as having urticaria more than 3 days per week for 6 consecutive weeks. Sixty-eight adults with CU who fulfilled the intake criteria and completed a course of cyclosporine were identified. After taking cyclosporine at an average dose of 1.8 ± 1.1 mg/kg, 53 (78%) patients attained complete remission defined as ≤ 1 day of hives per month. Recurrence occurred in only 7 patients; all achieved remission with resumption of cyclosporine. A history of hives (P = .01), shorter duration of urticaria (mean: 55.2 weeks vs 259.63 weeks; P = .03), and positive CU Index (P = .05) predicted a favorable response to cyclosporine. Notably, autologous serum skin testing, prior response to steroids, atopic status, or presence of antithyroid antibodies was not predictive. Male sex and a positive ANA trended toward significance (P = .1). Side effects were generally mild and seen in 35% of patients; all were reversible by dose reduction. CONCLUSION:Cyclosporine is an effective treatment for CU, and a history of hives, shorter duration of disease, and CU index ≥10 predict a successful response.
Authors: Paulo Ricardo Criado; Roberta Facchini Jardim Criado; Celina Wakisaka Maruta; Vitor Manoel Silva dos Reis Journal: An Bras Dermatol Date: 2015 Jan-Feb Impact factor: 1.896
Authors: Mario Sánchez-Borges; Ignacio J Ansotegui; Ilaria Baiardini; Jonathan Bernstein; Giorgio Walter Canonica; Motohiro Ebisawa; R Maximiliano Gomez; Sandra González-Diaz; Bryan Martin; Mário Morais de Almeida; Jose Antonio Ortega Martell Journal: World Allergy Organ J Date: 2021-06-03 Impact factor: 4.084