Therapeutic and QOL-improving Effects of Cetirizine Hydrochloride in Patients with Urticaria

Abstract

Urticaria is believed to decrease QOL in patients due to the repeated occurrence of wheal and itch. However, there have been a limited number of reported studies investigating interventions that improve QOL as well as reduce symptoms. We studied the effect of cetirizine hydrochloride on QOL of 26 patients with urticaria who had not previously received oral/injectable steroids within 2 weeks before study commencement. Cetirizine 10 mg was administered orally once daily for 4 weeks, and skin symptoms, itch (by visual analog scale [VAS]), severity of sleepiness, and QOL (by Dermatology Life Quality Index; [DLQI]) were evaluated. Five patients dropped out, and 21 patients were availabe for analysis (M/F, 9/12; mean age, 52.6 ± 13.5 years). At the end of the study, VAS significantly improved from 64.0 at baseline to 13.7. Both skin symptoms and itch resolved in 8 patients (38.1%). Regarditching sleepiness as a side effect, 19.2% of 26 patients had severe sleepiness; however, all patients with improved urticaria symptoms were nonetheless satisfied with the treatment. On the other hand, all three patients in whom there was no improvement of symptoms were dissatisfied with the treatment, regardless of sleepiness (sleepiness, n = 1; no sleepiness, n = 2). The total QOL score at baseline was 4.8; subscale scores were 2.7 for "symptoms and feelings," 1.2 for "daily living," and 0.7 for "workand school." At the end of the study, the total score was 1.3, showing a significant improvement (P<0.01), and other QOL subscales also showed significant improvements (all P<0.01). Taken together, improvements were observed not only in the assessments by physicians but also in the patient self-assessments (VAS and DLQI). Thus cetirizine seems very useful for the treatment of urticaria and thereby improves QOL of patients with this disease.