Kapp Alexander, Pichler Werner J
Department of Dermatology and Allergology, Hannover Medical University, Hannover, Germany.
Int J Dermatol. 2006 Apr;45(4):469-74. doi: 10.1111/j.1365-4632.2005.02609.x.
Chronic idiopathic urticaria (CIU) is defined by the almost daily presence of urticaria for at least 6 weeks without an identifiable cause. Symptoms include short-lived wheals, itching, and erythema. CIU impedes significantly a patient's quality of life (QoL). Levocetirizine is an antihistamine from the latest generation approved for CIU.
To investigate the efficacy of levocetirizine, 5 mg, and placebo for the symptoms and signs of CIU, as well as for the QoL and productivity.
The primary criteria of evaluation were the pruritus severity scores over 1 week of treatment and over 4 weeks. The QoL was assessed via the Dermatology Life Quality Index (DLQI).
Baseline pruritus severity scores were comparable in the two treatment groups (2.06+/-0.58). After 1 week, levocetirizine was superior to placebo and demonstrated a considerable efficacy (difference=0.78, P<0.001). This efficacy was maintained over the entire study period (4 weeks, P<0.001). The number and size of wheals were considerably reduced compared with placebo over 1 week and over the total treatment period (P <or= 0.001). This was paralleled by an improvement in the QoL (DLQI: 7.3 units in the levocetirizine group and 2.4 units in the placebo group) and a higher productivity at work in the levocetirizine group (3.0 workdays lost per patient per month in the placebo group, 0.3 in the levocetirizine group). No unexpected adverse events occurred.
Levocetirizine, 5 mg once daily, is an effective treatment for CIU, characterized not only by a rapid and sustained response, but also by an important improvement in QoL.
慢性特发性荨麻疹(CIU)的定义为荨麻疹几乎每日发作,持续至少6周且无明确病因。症状包括短暂性风团、瘙痒和红斑。CIU严重影响患者的生活质量(QoL)。左西替利嗪是新一代被批准用于CIU的抗组胺药。
研究5mg左西替利嗪和安慰剂对CIU症状体征、生活质量及工作效率的疗效。
评估的主要标准为治疗1周及4周期间的瘙痒严重程度评分。通过皮肤病生活质量指数(DLQI)评估生活质量。
两个治疗组的基线瘙痒严重程度评分相当(2.06±0.58)。1周后,左西替利嗪优于安慰剂,显示出显著疗效(差异=0.78,P<0.001)。在整个研究期间(4周,P<0.001)这种疗效得以维持。与安慰剂相比,1周及整个治疗期间风团的数量和大小均显著减少(P≤0.001)。与此同时,生活质量得到改善(DLQI:左西替利嗪组改善7.3个单位,安慰剂组改善2.4个单位),左西替利嗪组的工作效率更高(安慰剂组每位患者每月损失3.0个工作日,左西替利嗪组为0.3个工作日)。未发生意外不良事件。
每日一次口服5mg左西替利嗪是治疗CIU的有效方法,其特点不仅是起效迅速且疗效持续,还能显著改善生活质量。