A possible role for cyclooxygenase 2 inhibitors in the treatment of chronic urticaria

Anand, Miriam K.; Nelson, Harold S.; Dreskin, Stephen C.

doi:10.1067/mai.2003.1454

Cited by 15 publications

(5 citation statements)

References 11 publications

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“…[49] Zileuton, a 5-lipooxygenase inhibitor, which inhibits leukotriene generation has been found to be effective in improving chronic urticaria. Rofecoxib,[50] a newer COX-2 inhibitor, has also been tried in treating patients with refractory CIU with good results.…”

Section: Pharmacotherapymentioning

confidence: 99%

Chronic urticaria

et al. 2011

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Chronic urticaria (CU) is a disturbing allergic condition of the skin. Although frequently benign, it may sometimes be a red flag sign of a serious internal disease. A multitude of etiologies have been implicated in the causation of CU, including physical, infective, vasculitic, psychological and idiopathic. An autoimmune basis of most of the ‘idiopathic’ forms is now hypothesized. Histamine released from mast cells is the major effector in pathogenesis and it is clinically characterized by wheals that have a tendency to recur. Laboratory investigations aimed at a specific etiology are not always conclusive, though may be suggestive of an underlying condition. A clinical search for associated systemic disease is strongly advocated under appropriate circumstances. The mainstay of treatment remains H1 antihistaminics. These may be combined with complementary pharmacopeia in the form of H2 blockers, doxepin, nifedipine and leukotriene inhibitors. More radical therapy in the form of immunoglobulins, plasmapheresis and cyclophosphamide may be required for recalcitrant cases. Autologous transfusion and alternative remedies like acupuncture have prospects for future. A stepwise management results in favorable outcomes. An update on CU based on our experience with patients at a tertiary care centre is presented.

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Section: Pharmacotherapymentioning

confidence: 99%

Chronic urticaria

et al. 2011

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“…39 COX-2 inhibitors have the added advantage of not affecting platelet aggregation and may be useful in decreasing bleeding at the site of an early injury and can also be used perioperatively. 40 Several other uses for COX-2 inhibitors in the adult population, including the treatment of endometriosis-associated pain, 41 and chronic urticaria, 42 have been published.…”

Section: Discussionmentioning

confidence: 99%

COX-2 Inhibitors

Houston¹,

Teach²

2004

Pediatric Emergency Care

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“…Anand et al [17] proved that inhibition of the COX-2 inflammation pathway, in patients with chronic urticaria, may be clinically effective. A reduction of clinical symptoms and reduced demand for corticosteroids was observed in 5 of 8 refractory chronic idiopathic urticaria patients treated with antihistamines, antileukotrienes and corticosteroids, after adding rofecoxib (25 mg p.o.)…”

Section: Discussionmentioning

confidence: 99%

The effect of levocetirizine and montelukast on clinical symptoms, serum level and skin expression of COX-1 and COX-2 enzymes in patients suffering from chronic autoimmune urticaria – a pilot study

Korczyńska-Krawczyk

Kupryś‐Lipińska

Kupczyk

et al. 2020

pdia

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Introduction: Chronic autoimmune urticaria (CAU) lasts over 6 weeks and is characterized by circulating IgE autoantibodies or IgG against IgE or IgE receptor. Aim: To assess the clinical, laboratory and histological effects of 4-week levocetirizine and montelukast therapy in patients suffering from CAU. Material and methods: Of 296 tested patients with chronic urticaria 40 had a positive ASST test. Only 17 (16 female/1 male; medium age: 44 years) fulfilled all study inclusion/exclusion criteria. The study was designed as an open, randomized trial with two arms: levocetirizine or montelukast treatment for 4 weeks following a 2-week wash-out period. All participants completed urticaria activity score (UAS) and visual analogue scale (VAS) questionnaires before and after both therapies. Blood samples and skin bioptats were obtained before and after treatment to evaluate COX-1 and COX-2 serum concentrations and skin expression. Results: Clinical response to therapy measured with the UAS and VAS was better in the levocetirizine group. Both drugs caused a significant decrease in COX-1 and COX-2 serum level. COX-1 and COX-2 expression in epidermal and dermal inflammatory infiltration did not change significantly in either study group, but a significant decrease of COX-1 expression was observed when the groups were combined for analysis, and the decrease in COX-2 expression in the epidermis was of borderline significance. Conclusions: The effectiveness of levocetirizine and montelukast in treating CAU may be partly related to the reduction of COX-1 and COX-2 serum level and tissue expression, but further studies on a larger group of patients are needed to support this observation.

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A possible role for cyclooxygenase 2 inhibitors in the treatment of chronic urticaria

Cited by 15 publications

References 11 publications

Chronic urticaria

Chronic urticaria

COX-2 Inhibitors

The effect of levocetirizine and montelukast on clinical symptoms, serum level and skin expression of COX-1 and COX-2 enzymes in patients suffering from chronic autoimmune urticaria – a pilot study

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