Goyal Vippan, Gupta Anu, Gupta Onam, Lal Dhruvendra, Gill Manharan
Associate Professor and Head, Department of Dermatology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India.
Assistant Professor, Department of Dermatology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India.
J Clin Diagn Res. 2017 Mar;11(3):WC06-WC09. doi: 10.7860/JCDR/2017/23961.9550. Epub 2017 Mar 1.
Acute and chronic urticaria can result in severely impaired quality of life from pruritus and associated sleep lessness, as well as anxiety and depression. Various treatment modalities are available out of which second generation non sedating H1 antihistamines e.g., fexofenadine, loratidine, desloratadine, cetirizine, levocetirizine, ebastine etc., are used as the first line treatment.
To compare the safety and efficacy of ebastine 20 mg, ebastine 10 mg and levocetirizine 5 mg in the patients of urticaria.
A longitudinal study was conducted in dermatology Outpatient Department (OPD) of Adesh Institute of Medical Sciences and Research, Bathinda, India. A total of 150 patients between the age group 10-70 years, both men and women having urticaria were enrolled and divided into three groups of 50 each. Group A was given ebastine 20 mg OD, Group B was given ebastine 10 mg OD and Group C was given levocetirizine 5 mg OD. The patients were asked to scale their severity of disease over a period of follow up based on Urticarial Activity Score 7 (UAS7).
The mean age of patients was 32.82 years. The mean UAS 7 score at the end of 4 week was 1.08 with ebastine 20 mg, 1.98 with levocetirizine 5 mg and 3.98 with ebastine 10 mg. In group A, 40 out of 50 patients (i.e., 80%), in Group B 25 out of 50 (i.e., 50%) get UAS7=0 and in Group C, 35 (i.e., 70%) patients who got relieved of symptoms at the end of treatment. When the scores were redefined and categorized under relieved and not relieved, and comparison done between all three groups, then there was a significant difference in the number of patients getting relieved, with p<0.001 (highly significant). Levocetirizine 5 mg had shown more side effects like dryness of mouth and sedation as compare to ebastine irrespective of dosage. The comparison made between the number of patients developing side effects among the groups was highly significant (p<0.001) for all the side effects.
Ebastine 20 mg is found to have superior efficacy for treatment of Urticaria as compared to ebastine 10 mg but with levocetirizine 5 mg the results were almost similar. Tolerability of ebastine 20 mg is similar to ebastine 10 mg but with levocetirizine 5 mg there were more side effects and less tolerability.
急慢性荨麻疹会因瘙痒、相关的睡眠不足以及焦虑和抑郁而导致生活质量严重受损。有多种治疗方式可供选择,其中第二代非镇静性H1抗组胺药,如非索非那定、氯雷他定、地氯雷他定、西替利嗪、左西替利嗪、依巴斯汀等,被用作一线治疗药物。
比较20毫克依巴斯汀、10毫克依巴斯汀和5毫克左西替利嗪在荨麻疹患者中的安全性和疗效。
在印度巴辛达阿德什医学科学与研究学院皮肤科门诊进行了一项纵向研究。总共招募了150名年龄在10 - 70岁之间、患有荨麻疹的男性和女性患者,并将他们分成三组,每组50人。A组患者每日服用20毫克依巴斯汀,B组患者每日服用10毫克依巴斯汀,C组患者每日服用5毫克左西替利嗪。要求患者根据荨麻疹活动评分7(UAS7)在随访期间对疾病严重程度进行评分。
患者的平均年龄为32.82岁。4周结束时,20毫克依巴斯汀组的平均UAS 7评分为1.08,5毫克左西替利嗪组为1.98,10毫克依巴斯汀组为3.98。A组50名患者中有40名(即80%),B组50名中有25名(即50%)UAS7 = 0,C组有35名(即70%)患者在治疗结束时症状得到缓解。当将评分重新定义并分类为缓解和未缓解,并在所有三组之间进行比较时,缓解患者的数量存在显著差异,p<0.001(高度显著)。与依巴斯汀相比,无论剂量如何,5毫克左西替利嗪表现出更多副作用,如口干和镇静作用。各组之间出现副作用的患者数量比较对于所有副作用而言均高度显著(p<0.001)。
与10毫克依巴斯汀相比,发现20毫克依巴斯汀治疗荨麻疹疗效更佳,但与5毫克左西替利嗪的结果几乎相似。20毫克依巴斯汀的耐受性与10毫克依巴斯汀相似,但5毫克左西替利嗪有更多副作用且耐受性较差。