title: Safety and efficacy of cetirizine versus cetirizine plus ranitidine in chronic urticaria: Double-blind randomized placebo-controlled study.
abstract: BACKGROUND
  First-line treatment for chronic urticaria is H1 non-sedating antihistamines. When these fail, guidelines recommend combination with H2 antihistamines.
  
  
  OBJECTIVE
  We conducted a randomized, double-blind, placebo-controlled trial.
  
  
  METHODS
  Thirty-two patients with chronic urticaria were included. Group A (16 subjects) treated with cetirizine plus ranitidine and Group B (16 subjects) with cetirizine plus placebo, both for 30 days. Efficacy measures were Urticaria Activity Score (UAS), Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL) and time of symptom remission, safety measures were clinical and laboratory effects.
  
  
  RESULTS
  Complete remission was obtained in ten patients (62.5%) from Group A and seven patients (44%) from Group B (p = 0.28). The UAS in Group A was 1.53 ± 2.09 versus Group B 2.06 ± 1.34 (p = 0.20). The CU-Q2oL in Group A was 12.93 ± 19.20 versus Group B 12.68 ± 10.30 (p = 0.20). At the end of treatment, 13 patients (81%) from Group A and 14 patients (87.5%) from Group B had some type of adverse effect (p = 1.0).
  
  
  CONCLUSIONS
  Combination of cetirizine with ranitidine was not more effective than cetirizine alone in chronic urticaria. Both treatments resulted equally safe; however, our main limitation is the small sample size.
authors.affiliation: a Instituto Dermatologico de Jalisco "Dr. José Barba Rubio", Secretaría de Salud Jalisco , Zapopan , Jalisco , México and.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Guevara-Gutierrez
authors.affiliation: a Instituto Dermatologico de Jalisco "Dr. José Barba Rubio", Secretaría de Salud Jalisco , Zapopan , Jalisco , México and.
authors.forename: Sonia
authors.initials: S
authors.lastname: Bonilla-Lopez
authors.affiliation: a Instituto Dermatologico de Jalisco "Dr. José Barba Rubio", Secretaría de Salud Jalisco , Zapopan , Jalisco , México and.
authors.forename: Socorro
authors.initials: S
authors.lastname: Hernández-Arana
authors.affiliation: b Unidad Médica de Alta Especialidad, Hospital de Pediatría, CMNO, IMSS , Guadalajara , Jalisco , México.
authors.forename: Alberto
authors.initials: A
authors.lastname: Tlacuilo-Parra
mesh_terms: D000328:Adult; D000368:Aged; D017332:Cetirizine / Q000008:administration & dosage*; D002908:Chronic Disease; D004311:Double-Blind Method; D005260:Female; D039563:Histamine H1 Antagonists, Non-Sedating / Q000008:administration & dosage; D006635:Histamine H2 Antagonists / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011899:Ranitidine / Q000008:administration & dosage*; D014581:Urticaria / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D039563:Histamine H1 Antagonists, Non-Sedating; D006635:Histamine H2 Antagonists; D011899:Ranitidine; D017332:Cetirizine
keywords: Antihistamines; chronic urticaria; clinical trial; efficacy; safety; treatment