Categories
Change Password!
Reset Password!
Evidence for acute urticaria treatment is limited, with no clear advantage of adding corticosteroids to antihistamines, urging further high-quality clinical trials.
Acute urticaria is a common ailment marked by sudden-onset hives and itching, yet its management remains under-researched. A recent systematic review by Fariza M. S. Badloe and other researchers underscored the scarcity of robust clinical trials evaluating treatment approaches for acute urticaria, particularly the role of corticosteroids when added to antihistamines in severe cases.
A comprehensive search of PubMed and Web of Science determined studies on acute urticaria treatment. Using the PRISMA guidelines, a descriptive synthesis was executed, and the quality of randomized controlled trials (RCTs) was independently assessed using the Cochrane risk-of-bias tool. A total of 10 RCTs involving 857 volunteers were included. These studies primarily assessed two treatment strategies:
1. Corticosteroid addition to antihistamines
In 3 RCTs, corticosteroids like Prednisone were combined with antihistamines such as Cetirizine or Levocetirizine. However, 2 of these studies showed no vital improvement in symptoms when compared to antihistamine monotherapy.
The limited benefit raises questions about the necessity of corticosteroids in routine acute urticaria care, given their potential side effects.
2. H1-antihistamines versus H1+H2-antihistamines
Overall, 6 trials compared the effectiveness of first- and second-generation H1-antihistamines alone or in combination with H2-antihistamines.
In 2 out of 5 studies, the combination of Diphenhydramine (50 mg intravenously) with Ranitidine (50 mg intravenously) or Cimetidine (300 mg intravenously) illustrated superior relief of urticaria symptoms.
The most frequently encountered side effects were drowsiness and sedation. Thus, the existing urticaria guidelines predominantly focus on chronic urticaria, leaving acute urticaria treatment inadequately addressed. The limited number of small-scale, low-powered RCTs for acute urticaria management highlights a significant gap in the evidence base. Researchers call for robust, high-quality trials to establish clear management guidelines for this prevalent condition. More well-designed trials are warranted to determine the safety and efficiency of corticosteroids as an adjunct to antihistamines in severe acute urticaria cases.
Journal of the European Academy of Dermatology and Venereology
Treatment of acute urticaria: A systematic review
Fariza M. S. Badloe et al.
Comments (0)