title: Cinnarizine is a useful and well-tolerated drug in the treatment of acquired cold urticaria (ACU).
abstract: Old generation H1-type antihistamines are the standard therapeutic option for acquired cold urticaria (ACU), but adverse effects are common. New antihistamines are well tolerated but efficacy is often poor. The present study aims to evaluate efficacy and safety of cinnarizine in the treatment of ACU patients intolerant to old antihistamines and resistant to new drugs. We studied 14 patients (4 males and 10 females). Mean duration of the disease was 48.9 (range 7-102) months. Cold cube test was positive in 78.6 % of patients. Cold urticaria was idiopathic in 10 (71.4 %) patients. Cryoglobulins were detected in the serum of 4 cases (28.6 %). Cinnarizine (25 mg t.i.d.) was administered for 3 months, and then it was gently tapered off and stopped within 2 months. A complete or good response was obtained in 8 (57.1 %) and 2 (14.3 %) patients, respectively. Only two patients were unresponsive (21.4 %). Tapering off or stopping cinnarizine was followed by the relapse of cold urticaria in 7 cases (50.0 %). These patients were amenable to a second treatment cycle. Six patients (42.9 %) had a persistent remission. A patient interrupted the therapy because of severe vertigo. Three patients reported mild and transitory adverse effects including epigastralgia, weight gain and drowsiness. In conclusion, cinnarizine at high doses may be considered as an effective and well-tolerated treatment for ACU.
authors.affiliation: Clinical Immunology and Allergology Department, Brescia University School of Medicine, Azienda Ospedaliera Spedali Civili, Piazzale Spedali Civili, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Tosoni
authors.forename: Fabio
authors.initials: F
authors.lastname: Lodi-Rizzini
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Bettoni
authors.forename: Paola
authors.initials: P
authors.lastname: Toniati
authors.forename: Cristina
authors.initials: C
authors.lastname: Zane
authors.forename: Rossana
authors.initials: R
authors.lastname: Capezzera
authors.forename: Marina
authors.initials: M
authors.lastname: Venturini
authors.forename: Piergiacomo
authors.initials: P
authors.lastname: Calzavara-Pinton
authors.forename: Lucia
authors.initials: L
authors.lastname: Bettoni
mesh_terms: D000328:Adult; D018926:Anti-Allergic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002936:Cinnarizine / Q000009:adverse effects / Q000627:therapeutic use*; D003080:Cold Temperature / Q000009:adverse effects*; D003450:Cryoglobulins / Q000032:analysis; D005260:Female; D006634:Histamine H1 Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis; D008297:Male; D008875:Middle Aged; D014581:Urticaria / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology
chemical_list: D018926:Anti-Allergic Agents; D003450:Cryoglobulins; D006634:Histamine H1 Antagonists; D007073:Immunoglobulin E; D002936:Cinnarizine