Rupatadine is effective in the treatment of chronic spontaneous urticaria in children aged 2-11 years.
BACKGROUND
Recommendations in current guidelines for the treatment of chronic spontaneous urticaria (CSU) in infants and children are mostly based on extrapolation of data obtained in adults. This study reports the efficacy and safety of rupatadine, a modern H1 and PAF antagonist recently authorized in Europe for children with allergic rhinitis and CSU.


METHODS
A double-blind, randomized, parallel-group, multicentre, placebo-controlled compared study to desloratadine was carried out in children aged 2-11 years with CSU, with or without angio-oedema. Patients received either rupatadine (1 mg/ml), or desloratadine (0.5 mg/ml) or placebo once daily over 6 weeks. A modified 7-day cumulative Urticaria Activity Score (UAS7) was employed as the primary end-point.


RESULTS
The absolute change of UAS7 at 42 days showed statistically significant differences between active treatments vs. placebo (-5.5 ± 7.5 placebo, -11.8 ± 8.7 rupatadine and -10.6 ± 9.6 desloratadine; p < 0.001) and without differences between antihistamines compounds. There was a 55.8% decrease for rupatadine followed by desloratadine (-48.4%) and placebo (-30.3%). Rupatadine but not desloratadine was statistically superior to placebo in reduction of pruritus (-57%). Active treatments also showed a statistically better improvement in children's quality of life compared to placebo. Adverse events were uncommon and non-serious in both active groups.


CONCLUSIONS
Rupatadine is effective and well tolerated in the relief of urticaria symptoms, improving quality of life over 6 weeks in children with CSU. This is the first study using a modified UAS to assess severity and efficacy outcome in CSU in children.
Allergy Diagnostic and Clinical Research Unit, Department of Medicine, University of Cape Town Lung Institute, Cape Town, South Africa.
Paul
P
Potter
Newtown clinical Research, Johannerburg, South Africa.
Essack
E
Mitha
BAZ Megyei Kórház Gyermekegészségügyi Központ, Miskolc, Hungary.
László
L
Barkai
Allergy Unit, First Department of Pediatrics, Faculty of Medicine, Semmelweis U, Budapest Hungary.
Györgyi
G
Mezei
Clinical Development, R&D, J Uriach, Barcelona, Spain.
Eva
E
Santamaría
Clinical Development, R&D, J Uriach, Barcelona, Spain.
Iñaki
I
Izquierdo
Department of Dermatology and Allergy, Allergie-Centrum Charité/ECARF, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Marcus
M
Maurer
D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003533:Cyproheptadine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D039563:Histamine H1 Antagonists, Non-Sedating / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D006814:Hungary; D017336:Loratadine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D011788:Quality of Life; D012074:Remission Induction; D013019:South Africa; D013997:Time Factors; D016896:Treatment Outcome; D014581:Urticaria / Q000175:diagnosis / Q000188:drug therapy*
D039563:Histamine H1 Antagonists, Non-Sedating; C103639:rupatadine; D003533:Cyproheptadine; D017336:Loratadine; C121345:desloratadine
Chronic spontaneous urticaria; antihistamine; children; quality of life; rupatadine