Influence of initial treatment modality on long-term control of chronic idiopathic urticaria.
BACKGROUND
Chronic idiopathic urticaria (CIU) is a common cutaneous disorder but the influence of initial treatment modality on long-term control is not known. The aim of this study was to evaluate clinical features, and the influence of initial treatment modality on long-term control.


RESULTS
641 CIU patients were enrolled from the allergy clinic in a tertiary referral hospital. Disease duration, aggravating factors and treatment modality at each visit were evaluated. Times required to reach a controlled state were analyzed according to initial treatment modality, using Kaplan-Meier survival curves, the Cox proportional-hazards model, and propensity scores. Female to male ratio was 1.7: 1; mean age at onset was 40.5 years. The most common aggravating factors were food (33.5%), stress (31.5%) and fatigue (21.6%). Most patients (82.2%) used H1-antihistamines alone as initial treatment while 17% used a combination treatment with oral corticosteroids. There was no significant difference in the time taken to reach a controlled state between patients treated with single vs multiple H1-antihistamines or between those who received H1-antihistamine monotherapy vs. a combination therapy with oral corticosteroids.


CONCLUSIONS
The time required to control CIU is not reduced by use of multiple H1-antihistamines or oral corticosteroids in the initial treatment.
Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Sujeong
S
Kim
Seunghee
S
Baek
Bomi
B
Shin
Sun-young
SY
Yoon
So Young
SY
Park
Taehoon
T
Lee
Yoon Su
YS
Lee
Yun-Jeong
YJ
Bae
Hyouk Soo
HS
Kwon
You Sook
YS
Cho
Hee-Bom
HB
Moon
Tae-Bum
TB
Kim
D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D002908:Chronic Disease; D003710:Demography; D011307:Drug Prescriptions; D004359:Drug Therapy, Combination; D005260:Female; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D010818:Practice Patterns, Physicians'; D016016:Proportional Hazards Models; D014581:Urticaria / Q000188:drug therapy / Q000517:prevention & control* / Q000628:therapy*
D000305:Adrenal Cortex Hormones; D006634:Histamine H1 Antagonists