GOTHENBURG, Sweden - Updosing desloratadine by up to fourfold beyond the standard 5 mg for chronic spontaneous urticaria boosted treatment response with no impact on safety, according to the results of a randomized, double-blind controlled trial.

The findings support the current guidelines of the Global Allergy and Asthma European Network (GA2LEN), the European Dermatology Forum, the European Academy of Allergology and Clinical Immunology, and the World Allergy Organization (Allergy 2009;64:1427-43). When the guidelines were formulated, the recommendation to increase the dose of modern, nonsedating antihistamines by up to fourfold in patients with physical urticaria not adequately responsive to standard doses was based on expert opinion in the absence of relevant clinical trials.

The new randomized double-blind study shores up the recommendation, Dr. Elena Ardelean noted at the annual congress of the European Academy of Dermatology and Venereology.  

She reported on 29 patients with chronic spontaneous urticaria who were randomized to either 5 or 20 mg of desloratadine (Clarinex) on two separate occasions when they presented with urticaria symptoms. On another occasion they received no treatment. On all three occasions investigators evaluated them for 5 hours. The main end point was the number of spontaneously occurring wheals present at baseline versus 5 hours post treatment, compared with the spontaneous resolution rate with no treatment.

The reduction in wheals 5 hours after administration of 5 mg of desloratadine compared with baseline was 50% greater than with spontaneous resolution. But 20 mg resulted in a significantly greater 70% reduction, according to Dr. Ardelean of Charité University Hospital, Berlin.

There were no side effects associated with either dose of desloratadine in the study.

The trial was supported by GA2LEN. Dr. Ardelean said she had no relevant financial conflicts.

11/22/10  

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FROM THE ANNUAL CONGRESS OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY

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Vitals

Main Finding: Five mg of desloratadine resulted in a 50% reduction of wheals compared with spontaneous resolution, while 20 mg resulted in a significantly greater 70% reduction.

Data Source: Twenty-nine patients with chronic spontaneous urticaria who were randomized to either 5 or 20 mg of desloratadine on two separate occasions when they presented with urticaria symptoms.

Disclosures: The trial was supported by GA2LEN. Dr. Ardelean said she had no relevant financial conflicts.