Modern approaches to the appointment of antiohistamines in the resistant forms of chronicurticaria
Journal Title: Український журнал дерматології, венерології, косметології - Year 2018, Vol 0, Issue 4
Abstract
Objective — to conduct a review and analysis of thematic publications devoted to the aspects of etiopathogenesis and modern approaches to prescribing antihistamines in resistant forms of chronic urticaria. Materials and methods. The matic publications of domestic and foreign authors on the study of aspects of etiopathogenesis and treatment of urticaria, including reports on the results of randomized controlled clinical trials on the use of antihistamines in resistant forms of chronic urticaria. Results and discussion. According to the analysis of domestic and foreign publications, in recent years there has been an increase in the incidence of urticaria, which affects about 15—20 % of the population, as well as an increase in the share of chronic forms that are registered in 5 % of the population. Drugs of the first line of treating urticaria are antihistamines, with the advantage of providing modern non-consecutive H1-antihistamines of the second generation, but in many patients they do not provide a positive clinical effect in standard doses. In order to increase the effectiveness of treatment of resistant forms of chronic urticaria, еuropean recommendations recommend increasing the daily dose of antihistamines. As the results of randomized double-blind clinical trials show, a four-fold increase in the daily dose of levocetirizine and desloratadine improves the clinical outcome of treatment for chronic urticaria in approximately 3/4 of patients without development of adverse reactions, with better results in the treatment of levocetirizine. Conclusions. According to the materials of domestic and foreign publications, the current medical and social problem of today is the increase in the incidence of urticaria and an increase in the proportion of patients with a chronic course of dermatosis, resistant to standardized treatment methods. H1-antihistamines are first-line therapy in chronic urticaria, but many patients do not receive a satisfactory result when using their standard dose. For such patients, European recommendations recommend increasing the daily dose of antihistamines 4 times. According to the results of randomized clinical trials, a fourfold increase in the daily dose of levocetirizine and desloratadine significantly improves the clinical outcome of the treatment of resistant forms of chronic urticaria in 75 % of the patients without the development of complications or side effects; it was found that levocetirizine is more effective in both normal and increased (4 times) doses of the drug (from 5 to 20 mg per day).
Authors and Affiliations
O. I. Denysenko
Keywords
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- EP ID EP454864
- DOI 10.30978/UJDVK2018-4-30
- Views 126
- Downloads 0
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