Department of Internal Medicine and Infectious Diseases, University of Bari Medical School Bari, Italy.
Int J Immunopathol Pharmacol. 2011 Jan-Mar;24(1):195-200. doi: 10.1177/039463201102400123.
Common drugs in the therapy of chronic idiopathic urticaria (CIU) include antihistamines alone or combined with corticosteroids, but severe unresponsive patients require alternative treatments. This retrospective study aims to evaluate clinical response and safety of low-dose and long-term oral Cyclosporin-A (CyA) in unresponsive patients. One hundred and ten CIU patients, unresponsive to a previous treatment (antihistamines plus prednisone 0.2 mg/kg/day), received additional oral CyA 13 mg/kg/day for 6 months. The patients were subdivided into three groups (A, B, C) according to the different CyA doses. Parameters of clinical efficacy including pruritus, and size and number of wheals were evaluated at baseline, after three and six months. All adverse events were recorded. The mean total symptom severity score decreased by 63% in Group A, 76% in Group B, and 85% in Group C after 6 months. Total disappearance of the symptoms was recorded in 43 patients (39.1%): 7 (28%) of Group A; 12 (37.5%) of Group B and 24 (45%) of Group C. After a mean of 2 months from CyA suspension, 14 patients (11%) had recurrence of symptoms. Minor side effects were noted in 8 patients (7%). Our study indicates that low-dose, long-term CyA therapy is efficacious and safe in severe unresponsive CIU.
慢性特发性荨麻疹（CIU）的常规治疗药物包括单独使用抗组胺药或联合使用皮质类固醇，但严重无反应的患者需要替代治疗。本回顾性研究旨在评估低剂量、长期口服环孢素 A（CyA）治疗无反应患者的临床疗效和安全性。110 例 CIU 患者在接受抗组胺药加泼尼松 0.2mg/kg/天治疗后无反应，接受额外的口服 CyA 1-3mg/kg/天治疗 6 个月。根据不同的 CyA 剂量，患者分为三组（A、B、C）。在基线、治疗 3 个月和 6 个月时评估瘙痒、风团大小和数量等临床疗效参数。记录所有不良反应。治疗 6 个月后，A 组总症状严重程度评分下降 63%，B 组下降 76%，C 组下降 85%。43 例患者（39.1%）症状完全消失：A 组 7 例（28%）；B 组 12 例（37.5%）；C 组 24 例（45%）。CyA 停药后平均 2 个月，14 例患者（11%）出现症状复发。8 例患者出现轻微副作用（7%）。本研究表明，低剂量、长期 CyA 治疗对严重无反应性 CIU 有效且安全。
