Factors Associated With Refractoriness to an Up to Fourfold Dosage of Antihistamines in Isolated Chronic Spontaneous Urticaria
Issued Date
2022-11-01
Resource Type
ISSN
12034754
Scopus ID
2-s2.0-85139260482
Pubmed ID
36172833
Journal Title
Journal of Cutaneous Medicine and Surgery
Volume
26
Issue
6
Start Page
593
End Page
599
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Cutaneous Medicine and Surgery Vol.26 No.6 (2022) , 593-599
Suggested Citation
Wongjirattikarn R., Chaowattanapanit S., Foocharoen C., Sawanyawisuth K., Choonhakarn C., Julanon N., Utchariyaprasit E. Factors Associated With Refractoriness to an Up to Fourfold Dosage of Antihistamines in Isolated Chronic Spontaneous Urticaria. Journal of Cutaneous Medicine and Surgery Vol.26 No.6 (2022) , 593-599. 599. doi:10.1177/12034754221128819 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85419
Title
Factors Associated With Refractoriness to an Up to Fourfold Dosage of Antihistamines in Isolated Chronic Spontaneous Urticaria
Author's Affiliation
Other Contributor(s)
Abstract
Background: Chronic spontaneous urticaria (CSU) is a common skin disease and has a significant impact on patients’ quality of life. The aim of treatment is complete symptom control. Aim: To identify potential factors associated with antihistamine-refractory isolated CSU and to determine the factors that predict response to second-generation H1 antihistamines at dosages from one- to fourfold. Methods: We conducted a retrospective cohort study, which included adult patients diagnosed with isolated CSU and had complete symptom control. Clinical and laboratory findings were compared between the patients who were responsive to second-generation H1 antihistamines (< fourfold) and those who were refractory to a fourfold dose. Clinical and laboratory data were compared by dosage in the antihistamine-responsive group. Results: There were 182 isolated CSU patients who met the study criteria, of whom 150 (82.4%) were responsive to treatment with up to a fourfold dose of second-generation H1 antihistamines, while 32 (17.6%) were refractory. In univariate analysis, age at onset, body mass index, baseline Urticaria Activity Score-7 (UAS7), white blood cell count, total neutrophil count, neutrophil-lymphocyte ratio, platelet count, and new generation antihistamines were significantly higher in the antihistamine-refractory group. According to multivariate analysis, baseline UAS7 was the only independent factor associated with antihistamine-refractory isolated CSU (odds ratio 1.14, 95% CI 1.01-1.28, P =.03). In the antihistamine-responsive group, white blood cell count tended to predict response to antihistamine treatment (P <.001, 0.04, 0.34 between onefold and twofold, twofold and threefold, and threefold and fourfold, respectively). Conclusion: Baseline UAS7 was an independent factor associated with antihistamine-refractory isolated CSU.