SELECTED ARTICLES FROM THE RECENT LITERATURE 2005
9/21/05
Montelukast treatment of antihistamine-resistant chronic urticaria
Summary
Background - In some patients, chronic idiopathic urticaria (CIU) is not adequately controlled with H1 antihistamines (AH). Previous reported have suggested beneficial effects of leukotriene antagonist (LA) drugs such as montelukast ( Mont ) in CIU. But does LA therapy help CIU not well controlled by AH?
Findings - Sanada et al of the Hiroshima Univ in Japan evaluated the effects of at least one week treatment with Mont, 10mg/day in 25 patients with CIU not adequately controlled by AH. Prior therapy was also continued. Their impression was that there was "marked improvement" in 12 patients with Mont therapy. The CIU patients in whom such improvement was seen with Month treatment tended to be younger and with shorter duration of the CIU.
The authors concluded that Mont treatment may be worth trying in CIU not adequately controlled with AH.
Reference
Arch Dermatol Res 2005; July 26 E pub
Editor's Comments
Previous studies have suggested efficacy of Mont in some, but not all, patients with CIU. The potency of Mont appears to be about the same as most AH. However, it has been unclear whether Mont treatment is effective in CIU not controlled by AH. The findings described above would have been more impressive if the study had been in a randomized, double blind format comparing Mont and placebo treatment in CIU not well controlled with AH.
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