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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The objective of these three double-blind multi-centre studies was to determine whether terfenadine 120 mg once daily has similar efficacy and tolerability as the standard dosage of 60 mg twice daily in the treatment of chronic urticaria. A total of 252 patients were randomly allocated to two parallel groups and treated for 2 weeks with either regimen. Evaluation of efficacy was based on rating scales for investigator and patient, i.e. itch, number of wheals, wheal size and an overall rating of efficacy. A similar improvement was seen in all variables, and there were no statistically significant differences between treatment groups. The power of the studies combined is greater than 80%, i.e. sufficient to state convincingly that treatment effects are not different. Both treatments were also equally well tolerated.
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PMID:Terfenadine once daily in chronic urticaria. A multi-centre double-blind comparison of terfenadine once daily versus twice daily. 257 86

The efficacy of nifedipine, a calcium channel antagonist, in the treatment of chronic idiopathic urticaria, was evaluated in a double-blinded, placebo-controlled, crossover trial. Ten patients with chronic urticaria refractory to maximally tolerated doses of H1 and H2 antihistamines and in whom extensive evaluation failed to identify a cause for their urticaria were entered into the study. Patients continued with their prestudy antihistamine regimens. A study drug dosage was titrated in each patient and maintained throughout the trial. Patients were treated with placebo or nifedipine for 4 weeks and then crossed over to the other medication for 4 weeks. One patient withdrew because of unrelated medical illness, two patients withdrew after crossover to placebo because of intolerable urticaria, and seven patients completed the study. A beneficial effect of nifedipine was clearly demonstrated. Hive count, hive index, and itch index were all significantly improved at the end of 4 weeks of nifedipine treatment (p = 0.023, 0.003, and 0.003, respectively) but not placebo treatment (p = 0.194, 0.664, and 0.944, respectively). Additionally, end point hive index and itch index scores with nifedipine compared to corresponding placebo scores were significantly improved (p = 0.010 and 0.008, respectively). Nifedipine was well tolerated. Thus, when nifedipine is used as an adjunct to antihistamines, it appears to be a safe, efficacious drug for the treatment of chronic idiopathic urticaria.
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PMID:Therapy of chronic idiopathic urticaria with nifedipine: demonstration of beneficial effect in a double-blinded, placebo-controlled, crossover trial. 265 8

A female patient aged 39 with urticarial vasculitis is described. She has developed stubborn not itching blisters on the skin, suffered from periodic fevers, arthralgias; laboratory analyses have shown leukopenia, hypocomplementemia, immune complexes circulating in the blood and fixed in the skin vessel walls. Histologic examination has revealed leukocytoclastic vasculitis. The differential diagnosis between this condition, chronic urticaria, and lupus erythematosus is discussed.
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PMID:[Urticarial vasculitis]. 276 11

40 patients suffering from chronic urticaria were randomly treated with either Terfenadine or Astemizole. The treatment period was 8 days after a 4 day wash out phase with placebo. The intensity of the symptoms was quantified and daily recorded by the patients. Both antihistamines influenced significantly the intensity of the pruritus and the flares. With the used study design and dosage slight superiority of Astemizole over Terfenadine could be observed. Neither Astemizole nor Terfenadine showed sedation side effects. The average amount of the sedation symptom scores was during the therapy phase on the same level as during the placebo phase.
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PMID:[Comparison of astemizole and terfenadine in the treatment of chronic urticaria. A randomized double-blind study of 40 patients]. 285 14

45 patients with chronic urticaria were randomized to double blind therapy with terfenadine an H1-antihistamine or ranitidine, an H2-antihistamine, or a combination of both drugs. The therapeutic response was assessed by diary scores. The primary effect variable was "itching". The inference-statistical evaluation of the patient scores showed varying therapeutic effects. The Type-I error was p = 0.015. Itching was reported to be significantly lower by patients receiving both drugs than by those who were given terfenadine alone, while ranitidine in monotherapy had no significant effect on itching. A similar trend was seen in assessment of the severity of weals, while the treatment regimens had no influence on swelling.
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PMID:Treatment of chronic urticaria with terfenadine and ranitidine. A randomized double-blind study in 45 patients. 287 11

Two new non-sedating antihistamines, astemizole (10 mg per day) and terfenadine (120 mg per day), were compared in a double-blind randomized study in 42 adult patients suffering from chronic urticaria. The trial lasted 4 weeks. Patients were evaluated at 2 and 4 weeks and kept a daily diary of their symptoms. There was a statistically significant decrease in pruritus, erythema and urticaria papules in both groups throughout the study. Changes in papule size, number and frequency were greater in the astemizole group though not significantly different to the terfenadine group. The effect of astemizole increased with time whereas that of terfenadine decreased after about 3 weeks of treatment. Astemizole was globally considered to be the most effective drug by both investigator and patients, with excellent/good results in 77% of the patients compared with 55% to 60% in the terfenadine group. Both drugs were reported to be more effective and faster acting than other antihistamines taken previously. Side-effects were infrequent and minor in both groups.
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PMID:Double-blind comparison of astemizole and terfenadine in the treatment of chronic urticaria. 288 54

Astemizole is a new H1 histamine-receptor antagonist that has a long elimination half-life and high H1-receptor affinity. This double-blind study evaluated the safety and efficacy of astemizole in the treatment of chronic idiopathic urticaria (more than or equal to 3 months). Seventeen male and 34 female adult patients with chronic idiopathic urticaria entered the 2-month study. After a 48- to 72-hour washout, half the subjects were prerandomized to receive astemizole (10 mg), and the other half received placebo. Placebo-treated patients who were unable to complete the full 8 weeks because of uncontrolled chronic urticaria symptoms were entered into a 2-month open astemizole trial. Treatment with astemizole, as measured at the end point of each patient's treatment and compared to placebo, resulted in significant improvement of pruritus, erythema, number of wheals, frequency of urticarial attacks, and control of urticaria (p less than or equal to 0.03). The overall response to astemizole was significantly better than for placebo, according to both the investigator's and the patient's global evaluations (p less than 0.01) and as indicated by dropouts caused by treatment failure with placebo (p = 0.005). Six of 26 (24%) of the placebo-treated patients in the double-blind study had good to excellent results on the basis of global assessments. Thirteen of 16 patients with placebo-treatment failures who received astemizole in the open trial improved significantly from baseline symptoms of pruritus, erythema, and number of wheals (p less than or equal to 0.05). No significant side effects were reported except mild sedation in three astemizole-treated subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The treatment of mild to severe chronic idiopathic urticaria with astemizole: double-blind and open trials. 309 9

The therapeutic results of hypnosis with relaxation therapy were evaluated in 15 patients with chronic urticaria of 7.8 years' average duration. Compared with baseline and control session values, the hypnosis session provided relief of pruritus as measured by three self-report parameters. There was no change in the number of hives. All subjects were given a standard test for hypnotizability. Assuming that the results were not biased by their preceding relaxation sessions, we determined that six subjects were hypnotizable and nine were nonhypnotizable. Subjects in both groups improved symptomatically, but hypnotizable subjects had fewer hives and became more symptomatic during the control (testing and history taking) session. Hypnotizable subjects also more frequently related stress as a causative factor. At a follow-up examination five to 14 months after the completion of the experimental sessions, six patients were free of hives and an additional seven reported improvement.
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PMID:Effects of relaxation therapy and hypnotizability in chronic urticaria. 330 May 66

Recent studies indicate that antidepressant medications may be effective treatments for dermatologic disorders such as chronic urticaria and angioedema, nocturnal pruritus in atopic eczema, and postherpetic neuralgia, even in the absence of coexisting psychopathologic conditions. Their efficacy may be related to their antihistaminic, anticholinergic, and centrally mediated analgesic effects and appears to be independent of their antidepressant effect. It is likely, therefore, that more dermatologists will be prescribing these drugs without a psychiatric consultation.
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PMID:Antidepressant drugs in dermatology. An update. 357 46

A case of chronic urticaria associated with thyroiditis is described. The diagnosis of autoimmune thyroid disease (Hashimoto's disease) rested on the presence of nodular goiter, thyroid dysfunction and significantly elevated thyroid microsomal antibodies (greater than 6,400). Skin biopsy showed changes suggestive of leucocytoclastic vasculitis. Immunological studies showed few abnormalities (low titers of antinuclear antibodies and rheumatoid factor) but a search for circulating immune complexes was negative, and serum complement levels were within normal range. The patient complained of severe pruritus and polyarthralgia but no systemic involvement occurred. Urticaria vasculitis has never previously been described in association with thyroid autoimmunity. This suggests the possibility of an autoimmune cause of urticaria. The urticaria improved and disappeared after treatment with levothyroxine. The frequent clinical latency of thyroiditis warrants systematic testing for circulating anti-microsome antibodies in women presenting with an apparently idiopathic chronic urticaria.
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PMID:[Systemic urticaria associated with autoimmune thyroiditis]. 358 5


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