title: Efficacy of leukotriene receptor antagonist with anti-H1 receptor antagonist plus anti-H2 receptor antagonist for treatment of refractory chronic idiopathic urticaria.
abstract: BACKGROUND
  The efficacy of the combination of leukotriene receptor antagonist (LRA) and H1 antihistamine was similar to the synergistic regimen of H1 and H2 antihistamine for treatment of chronic idiopathic urticaria (CIU). However, the effective rates of these two regimens were only 53.3% and 63.3%, respectively.
  
  
  METHODS
  A total of 50 with two combined therapeutic regimens treatment ineffective patients were evaluated. Patients were single blinded and randomly assigned to one of two medication groups that received the following regimens for 4 weeks: Group A (n = 30), combination of LRA, H1 antihistamine and H2 antihistamine. Group B (n = 20) continued with the previously taken two combination regimens. The treatment efficacy was measured by daily urticaria activity score (UAS) of wheal and itch. A positive therapeutic response was defined as a reduction to <25% of baseline weekly UAS, while a relapse was a return to >75% of baseline weekly UAS.
  
  
  RESULTS
  At the end of 4 weeks, the UAS response to treatment of Group A was decreased from 35.2% to 21.2%, and the Group B was persisted with 33.9% as before the treatment.
  
  
  CONCLUSIONS
  The combination of LRA, H2 antihistamine and H1 antihistamine is promising for the refractory CIU cases, which were refractory for two combined therapeutic regimens.
authors.affiliation: Department of Pediatrics, Taipei City Hospital , Renai Branch , Taiwan and.
authors.forename: Kong-Sang
authors.initials: KS
authors.lastname: Wan
authors.forename: Yung-Sen
authors.initials: YS
authors.lastname: Chang
mesh_terms: D000328:Adult; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D005260:Female; D006634:Histamine H1 Antagonists / Q000627:therapeutic use*; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D016896:Treatment Outcome; D014581:Urticaria / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D018926:Anti-Allergic Agents; D006634:Histamine H1 Antagonists; D006635:Histamine H2 Antagonists; D020024:Leukotriene Antagonists