ABSTRACT
Background: Second generation antihistamines are first line therapy for chronic spontaneous urticaria (CSU). Sedation has been always a concern as a side effect of antihistamine for both patients and treating dermatologist. It is always better to prefer non-sedative antihistamine for CSU. Bepotastine is such promising non-sedative agent. Aim and Objectives: The objective of the study was to compare the efficacy and safety of bepotastine and levocetirizine in patients of CSU. Materials and Methods: This is a double arm, open label, randomized, and controlled study. Out of 99 patients, 50 patients belonged to Group A while 49 belonged to Group B. Subjects in Group A received bepotastine 10 mg twice daily while subjects in Group B received levocetirizine 5 mg once daily for 8 weeks. Patients were evaluated at baseline, day 14, day 28, and day 56 using Urticaria Activity Score (UAS) and Urticaria Control Test (UCT) for efficacy; and visual analog scale (VAS) for safety, that is, sedation. Results: The fall in mean UAS scores was statistically significant at day 14, day 28, and day 56 for both Groups A and B (P < 0.05) on intragroup comparison. While comparing the overall improvement between the two groups, there was no significant difference in UAS and UCT score at day 14, day 28, and day 56 between Group A and Group B, respectively (P > 0.05). At day 56, there was significant difference in mean VAS of Group A and B. Only one patient in Group B developed headache. Conclusion: Thus, both levocetirizine and bepotastine are equally effective for the treatment of CSU. Bepotastine has less sedative potential than levocetirizine.
ABSTRACT
Sheetapitta is a clinical condition caused due to vitiation of Tridosha mainly by the contact of Sheetalavayu. It is characterized by Varati Damstravat Shotha (wheals), Kandu (itching), Daha (burning sensation), Toda (pricking pain), Jwara (fever) and Chardi (vomiting). Sheetapitta analogous to urticaria of western medicine. Urticaria is a vascular reaction pattern characterized by transient, erythematous and edematous wheals or papules of varying sizes and shapes which are usually pruritic. Episodes lasting more than 6 weeks are regarded as chronic urticaria. Present study is a single group open clinical trial with pre and post-test design with a sample size of 33 subjects. The diagnosis was based on the signs and symptoms of Sheetapitta vis-à-vis chronic urticaria and the assessment was based on Urticaria Activity Score which includes wheals and itch as its parameter. Subjects were administered with Virechana Karma followed by Ardraka Khandawith Amruta Rajanyadi Kashaya as Anupana for 30 days after Virechana Karma. The result obtained after the completion of intervention showed statistically highly significant with the P value 0.001 and also overall clinical improvement showed significant result in reducing the signs and symptoms of Sheetapitta vis-à-vis chronic urticaria. Sheetapitta being Tridoshajanya, Virechana Karma helped in Tridosha Nirharana (expelling dosha). Ardraka Khanda being Agnideepaka (appetiser), Sheeta Pittahara (disease pacifying action) and Rasayana (rejuvinator) followed by Amruta Rajanyadi Kashaya which is Kapha-Pitta Hara, Dahahara (reducing burning sensation) and Kanduhara (anti-itch) properties pacified the signs and symptoms of Sheetapitta. In combination of both Virechana Karma and Ardraka Khanda with Amruta- Rajanyadi Kashaya, majority of the subjects attained pacification of urticarial wheals and itching.
ABSTRACT
Introduction: Nearly 20% of the total population suffer from urticaria for a minimum of one episode during the entire lifetime.Second-generation antihistamines are preferred in majority cases of urticaria.Objective: The present survey was undertaken in pursuit of analyzing the effectiveness and safety of bepotastine in thetreatment of chronic urticaria (CU).Materials and Methods: This was a retrospective questionnaire-based survey. Doctors were identified from four directionalzones of the country, and each was given prevalidated questionnaire booklets. Clinical response was evaluated by urticariaactivity score (UAS) at baseline (D0), day 14 (D14), and day 28 (D28). All the adverse effects were monitored for severity.Specifically, sedation was closely monitored for its occurrence and severity.Results: A total of 50 doctors completed the survey involving 226 patients. The mean UAS score at D0/baseline was 3.47which reduced to 1.71 at D14 and 0.73 at D28. 78 patients were having UAS score in the range of 1–2, 89 patients in 3–4, and59 patients in the range of 5–6 at D0. 59 patients were encountered in Grade 5–6 at D0, which reduced to 45 patients at D14and 29 patients at D28, while 89 patients in score range 3–4 at D0 reduced to 68 at D14 and 38 at D28. Sedation was reportedin only 15 patients (6.6%) that too majority had mild sedation, rated in sedation scale range of 0–5.Conclusion: The present survey indicates that bepotastine is efficacious and safe in the management of CU.
ABSTRACT
Antecedentes: Se ha incrementado la evidencia que demuestra la conexión entre la diferencia/insuficiencia de Vitamina D con aumento de la incidencia, severidad y actividad de trastornos inmunes-inflamatorios. La urticaria crónica es un trastorno de la piel caracterizado por ronchas recurrentes durante más de 6 semanas, y se divide en espontánea o inducible por estímulos físicos. El objetivo principal del siguiente trabajo fue estudiar la relación que pueden tener los niveles de Vitamina D en suero de pacientes con diagnóstico de urticaria crónica espontánea (UCE) que asisten al Servicio de Alergia e Inmunología del Hospital Nacional de Clínicas y compararlos con un grupo control de pacientes sin urticaria. Material y Métodos: Es un estudio descriptivo, prospectivo en donde se estudiaron 27 pacientes con diagnóstico de urticaria crónica espontánea. Luego de confeccionar Historia Clínica compatible con el diagnóstico, se les otorgó un test (UAS7) para evaluar la gravedad de la enfermedad, se realizaron prubeas cutáneas con aeroalergénos y alimentos, se realizó test intradérmico de suero autólogo, laboratorio que incluía además el hemograma, el perfil tiroideo y hepático, serología para virus (Hepatitis B y C, VDRL y HIV), se dosaron niveles de Ig A, G, M, E, y de Vitamina D (D2+D3) a todos los pacientes para luego analizar los resultados y comparar con un grupo control de 16 adultos sanos. Resultados: Hubo diferencias significativas entre los valores séricos de Vitamina D del grupo con urticaria crónica con respecto al control p<0,0001. Conclusión: Este estudio encontró que los pacientes con UCE tienen valores séricos disminuidos de Vitamina D. Son necesarios más estudios acerca del rol de la Vitamina D en la patogénesis de la Urticaria Crónica.
Evidence demostrates the connection between vitamin D deficiency/insufficiency with increased incidence, severity and activity of immune-inflammatory disorders. Chronic urticaria is a skin disorder characterized by recurring hives for mores than 6 weeks, and is divided into spontaneous or inducible by physical stimuli. The main objective of this study was to study the relationship that serum vitamin D levels may have in patients diagnosed with Spontaneous Chronic Urticaria (SCU) who attend the Allergy and Immunology Service of the National Hospital of Clinics and compare them with a control group of patients without urticaria. Materla and Methods: This is a prospective descriptive study in which 27 patients with chronic urticaria spontaneously diagnosed were studied. After making clinical history compatible with the diagnosis, they were given a test (UAS7) to evaluate the severity of the disease. In adition to the hemogram, the thyroid and hepatic profile, serology for virus (Hepatitis B, C, VDRL and VIH), serum levels of immunoglobulins A, G, M, E and vitamin D (D2+D3) to all patients and then analyzed the results and compared with a control group of 16 healthy adults. Results: There were significant differences between serum vitamin D levels in the group with chronic urticaria compared to the control group (p<0,0001) Conclusion: This study found that patients with SCU have decreased serum vitamin D values. More studies are needed about the role of vitamin D in the pathogenesis of UC.
ABSTRACT
PURPOSE: Chronic urticaria (CU) has a substantial impact on the quality of life. Little clinical data on the prognosis of CU has been reported. This study aimed to investigate the control status and remission rate of CU and to explore potential predictors of good responses to the treatment during a 6-month treatment period. METHODS: A total of 75 patients with chronic spontaneous urticaria (CSU) were enrolled from 3 university hospitals in Korea. Urticaria control state was classified into 2 groups: group I (remission and well-controlled) and group II (partly and uncontrolled). CU-specific quality of life (CU-QoL) and the urticaria activity score (UAS) were measured before and after the treatment. Autologous serum skin test (ASST), and anti-nuclear and anti-thyroid antibodies were measured at the enrollment into the study. Aspirin intolerance was confirmed by an oral provocation test. RESULTS: Of 59 patients completing the study, 21 (35.6%) arrived at well-controlled status and only 2 (3.4%) achieved remission, whereas 26 (44.1%) remained at partly controlled status and 10 (16.9%) were at uncontrolled status. Mean changes in CU-QoL (36.5+/-2.7 vs 20.6+/-4.3, P=0.017) and UAS (-7.9+/-0.8 vs -3.0+/-1.0, P=0.001) were significantly different between groups I and II. The presence of serum autoantibodies and aspirin intolerance had no influence on the control of urticaria in this study. However, ASST positivity was identified as a significant predictor of CU control in multivariate analysis (OR=6.106, P=0.017). CONCLUSIONS: The proportion of CSU patients that achieved remission or a well-controlled state was 39% for the 6 months of stepwise treatment. Longer observations are necessary to assess the exact prognosis of CSU. ASST results may be a useful parameter for predicting a better response to treatment and both UAS and CU-QoL are helpful to monitor therapeutic response.