A comparison of new nonsedating and classical antihistamines in the treatment of primary acquired cold urticaria (ACU).
The efficacy of the new nonsedating antihistamines loratadine and cetirizine was compared in a randomized, single-blind, crossover, controlled study with that of the classical antihistamines cyproheptadine and ketotifen in seven patients with primary acquired cold urticaria (ACU). The patients received each of the four drugs for 14 consecutive days with a 7-day interval between drugs. We evaluated clinical symptomatology, adverse effects, minimum time of cold contact stimulation required to induce an immediate coalescent wheal (CSTT), and inhibition of histamine-induced wheal response. Both loratadine and cetirizine showed suppression of symptoms with infrequent adverse effects. Important side-effects were observed in patients receiving cyproheptadine. Improvement in CSTT was statistically significant for all drugs compared with baseline values, without differences among them. The histamine-induced skin test was significantly inhibited by all antihistamines. Wheal reductions were 34.6% for loratadine and 50.9% for cetirizine. This study suggests that both loratadine and cetirizine may be effective in the treatment of primary ACU.
Allergy Unit, Hospital La Paz, Madrid, Spain.
F
F
Villas Martínez
F J
FJ
Contreras
J M
JM
López Cazaña
M C
MC
López Serrano
F
F
Martínez Alzamora
D000328:Adult; D000368:Aged; D017332:Cetirizine / Q000009:adverse effects / Q000627:therapeutic use; D003080:Cold Temperature / Q000009:adverse effects*; D003533:Cyproheptadine / Q000009:adverse effects / Q000627:therapeutic use; D004361:Drug Tolerance; D005260:Female; D006634:Histamine H1 Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007665:Ketotifen / Q000009:adverse effects / Q000627:therapeutic use; D017336:Loratadine / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D012894:Sleep Stages / Q000187:drug effects; D014581:Urticaria / Q000188:drug therapy* / Q000209:etiology*
D006634:Histamine H1 Antagonists; D003533:Cyproheptadine; D017336:Loratadine; D007665:Ketotifen; D017332:Cetirizine