Department of Dermatology, Kyoto University Graduate School of Medicine , Kyoto , Japan.
J Dermatolog Treat. 2013 Dec;24(6):477-80. doi: 10.3109/09546634.2013.789472. Epub 2013 May 21.
H1-antihistamines are the first-line treatment of chronic idiopathic urticaria (CIU), but CIU is occasionally refractory to the conventional treatment doses. Guidelines in Europe recommend increasing doses as second-line therapy; however, more supportive evidences for these guidelines are required to justify this management strategy.
In this study, the authors evaluated the effect of conventional and double doses of fexofenadine HCl on CIU and on histamine-induced skin responses by iontophoresis using visual and laser Doppler imaging scales in healthy donors.
Cutaneous manifestations in CIU and histamine-induced flare and itch in healthy donors were attenuated more extensively by a double dose of fexofenadine HCl compared with a conventional dose.
The above findings support the management strategy that increasing the dose of non-sedative antihistamines is the second-line treatment choice for refractory CIU even in Japanese populations.
H1 抗组胺药是慢性特发性荨麻疹（CIU）的一线治疗药物，但 CIU 偶尔对常规治疗剂量无反应。欧洲指南建议将剂量增加作为二线治疗；然而，需要更多支持这些指南的证据来证明这种管理策略的合理性。
在这项研究中，作者评估了盐酸非索非那定常规剂量和双倍剂量对 CIU 的影响，并通过离子电渗法使用视觉和激光多普勒成像量表在健康供体中评估了组胺诱导的皮肤反应。
与常规剂量相比，盐酸非索非那定的双倍剂量更能广泛减轻 CIU 的皮肤表现以及健康供体中组胺诱导的红斑和瘙痒。
上述发现支持这样一种管理策略，即增加非镇静性抗组胺药的剂量是难治性 CIU 的二线治疗选择，即使在日本人群中也是如此。
