Natarajan Subramanian, Subramanian Poonam
Allergologist and Pulmonologist, Department of Pulmonary Medicine, The Lung Centre, Office No 404, 4th Floor Marathon Chambers, P K Road, Mulund West, Mumbai, Maharashtra, India.
Allergologist and Pulmonologist, The Lung Centre, Office NO 104, First Floor Trinity Apartments, Uthalsar Road, Thane West, Maharashtra, India.
Indian J Dermatol. 2022 Sep-Oct;67(5):518-523. doi: 10.4103/ijd.ijd_718_21.
Chronic idiopathic urticaria (CIU) is a chronic relapsing disease with hives for a period of six weeks or more. It has a significant impact on the physical and mental well-being of patients.
Open-label non-blinded study of over 600 patients diagnosed with CIU was done. The aim of the study was to observe the following: 1. Characteristics of patients of anti-histaminic resistant CIU, 2. Efficacy of cyclosporin and any adverse events in the study population and 3. Prognosis and relapse rates of these patients at the end of one year.
Detailed history taking and guided clinical evaluation were done to include chronic resistant urticarias in the study and their clinical characteristics and prognosis were studied.
A total of 610 patients were diagnosed with CIU over a period of four years. Of these, 47 patients (7.7%) were diagnosed with anti-histaminic resistant urticaria. Of these, 30 patients (4.9%) who took treatment with cyclosporin at the above dosages were included in group 1. Rest 17 patients were in group 2 that were continued on anti-histaminics. Patients in cyclosporin group 1 showed a significant reduction in symptom scores as compared with group 2 at the end of six months. A lower need for corticosteroid therapy was noted in the cyclosporin group.
Cyclosporin in low doses is very useful in anti-histaminic resistant urticaria with the duration of therapy being six months. It is cost-effective in low and medium-income countries and easily available.
慢性特发性荨麻疹(CIU)是一种慢性复发性疾病,风疹块症状持续六周或更长时间。它对患者的身心健康有重大影响。
对600多名被诊断为CIU的患者进行了开放标签非盲法研究。该研究的目的是观察以下内容:1. 抗组胺药耐药性CIU患者的特征;2. 环孢素在研究人群中的疗效及任何不良事件;3. 这些患者在一年结束时的预后和复发率。
进行了详细的病史采集和指导性临床评估,以纳入研究中的慢性耐药性荨麻疹,并研究其临床特征和预后。
在四年期间,共有610名患者被诊断为CIU。其中,47名患者(7.7%)被诊断为抗组胺药耐药性荨麻疹。其中,30名按上述剂量接受环孢素治疗的患者被纳入第1组。其余17名患者在第2组,继续使用抗组胺药。与第2组相比,第1组环孢素治疗的患者在六个月结束时症状评分显著降低。环孢素组对皮质类固醇治疗的需求较低。
低剂量环孢素对治疗抗组胺药耐药性荨麻疹非常有用,治疗持续时间为六个月。在低收入和中等收入国家,它具有成本效益且易于获得。