The Scope of Pharmacological and Clinical Effects of Modern Antihistamines, With a Special Focus on Rupatadine: Section 3. Effective New Antihistamines in Dermatology: Urticaria and Other Conditions

摘要

Modern nonsedating antihistamines that target theH1-receptor are the drugs of choice in the treatment ofhistamine-mediated inflammatory skin disorders such asurticaria. The modern agents, including rupatadine, thelatest addition to our repertoire, lack the unwanted effectsof older generation antihistamines (sedation and anticholinergiceffects) and exhibit additional anti-inflammatoryeffects. Rupatadine, for example, has been shown to inhibitplatelet-activating factor (PAF) and mast cell activation. Inwell-controlled clinical trials rupatadine has been shown tobe safe and effective in treating patients with chronicspontaneous urticaria. For example at a dosage of 20 mg oncedaily it produced a 50% reduction of urticarial activity in 3 of4 patients treated and more than half the patients achieved areduction in symptoms exceeding 75%. Importantly, the clinicalbenefits obtained in these patients were mirrored by improvementsin their quality of life. In addition, treatment with rupatadine20 mg once daily was shown to be effective in treatingpatients suffering from cold urticaria. Thus, rupatadine, a second-generationantihistamine that is also a potent PAF-antagonist,is a novel and promising new treatment option for patientswith urticaria.