A double-blind, placebo-controlled trial of fexofenadine HCl in the treatment of chronic idiopathic urticaria.
BACKGROUND
Symptoms of chronic idiopathic urticaria (CIU) include relentless itching and painful wheals, which can be physically and psychologically debilitating. Half of all patients with urticaria have angioedema, which is often disfiguring.


OBJECTIVE
To evaluate the safety and efficacy of fexofenadine HCl for the treatment of CIU symptoms.


METHODS
In this 4-week, multicenter, placebo-controlled study, 439 patients with moderate to severe pruritus and urticaria received 1 of 4 oral doses of fexofenadine HCl (20, 60, 120, or 240 mg twice a day) or placebo. Patients reflectively assessed (over the previous 12 hours) the severity of pruritus, the number of wheals, and the interference with sleep (7 AM) and normal activities (7 PM) due to urticaria. Efficacy measures included a change from baseline of daily mean pruritus score (MPS), daily mean number of wheals (MNW) score, daily mean total symptom score (MTSS) (ie, the sum of the wheal and pruritus scores), and mean interference with sleep and daily activities due to urticaria.


RESULTS
All 4 doses of fexofenadine were statistically superior to placebo (P </=.0238) for MPS, MNW score, and MTSS. Patients receiving fexofenadine HCl also experienced significantly less interference with sleep and daily activities than patients receiving placebo (P </=.0001). Efficacy results were similar in the 60-, 120-, and 240-mg groups and were quantitatively better than those in the 20-mg group. Adverse events were mild and occurred with similar incidence in all treatment groups.


CONCLUSIONS
Fexofenadine HCl is well tolerated and is statistically superior to placebo in reducing signs and symptoms of CIU and in ameliorating interference with sleep and daily activities due to urticaria. Doses of 60 mg twice a day or greater are most effective.
Finn
A F
AF
National Urticaria Research and Treatment Center, Allergy and Asthma Centers of Charleston, PA, SC, USA.
Kaplan
A P
AP
Fretwell
R
R
Qu
R
R
Long
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002908:Chronic Disease; D004311:Double-Blind Method; D005260:Female; D006634:Histamine H1 Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011537:Pruritus / Q000188:drug therapy*; D016593:Terfenadine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome; D014581:Urticaria / Q000188:drug therapy*
D006634:Histamine H1 Antagonists; D016593:Terfenadine; C093230:fexofenadine