Therapeutic Efficacy of Low-dose Cyclosporine in Chronic Idiopathic Urticaria

Kim, Byung Soo; Cho, Hyun Ho; Ko, Hyun Chang; Kim, Sung Joon; Oh, Chang Keun; Kwon, Kyung Sool; Kim, Moon Bum

Abstract

BACKGROUND: Chronic idiopathic urticaria (CIU) has a major impact on patients' quality of life. However the management of CIU has sometimes been challenging to physicians, with little response to conventional therapy like antihistamines.
OBJECTIVE
This study was aimed to determine the effectiveness and safety of low-dose cyclosporine for the treatment of recalcitrant CIU with a positive autologous serum skin test (ASST).
METHODS
Thirty CIU patients who were unresponsive to conventional antihistamine therapy were treated for 3 consecutive months with low-dose cyclosporine (2~3 mg/kg/day) and fexofenadine (180 mg/day). The clinical efficacy was measured at baseline, week 1, 2, and month 1, 2 and 3. CIU sign and symptom scores were assessed using 4-point scales for pruritus, number of hives, size of largest hive, interference with sleep, and interference with daily activities. Global assessment of the severity by patients and any side effects were also measured at every visit.
RESULTS
Low-dose cyclosporine significantly improved the total CIU scores. In addition, the interference with sleep was reduced and the performance of daily activities improved in accordance with patient's global assessment of urticaria severity after 3 month of treatment. Moreover there were no significant side effects to suggest stopping cyclosporine administration.
CONCLUSION
These results show that low-dose cyclosporine therapy might be a good therapeutic alternative in CIU patients who are unresponsive to conventional treatments.