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Combining dipyridamole and cilostazol with up-dosing antihistamines improves outcomes in chronic spontaneous urticaria with high D-dimer levels: A randomized controlled trial.
- Source :
-
Experimental dermatology [Exp Dermatol] 2024 Aug; Vol. 33 (8), pp. e15168. - Publication Year :
- 2024
-
Abstract
- In a double-blind, randomized controlled trial, we investigated the effectiveness of adding antiplatelet drugs to up-dosing antihistamines for the treatment of chronic spontaneous urticaria (CSU) in patients with elevated D-dimer levels who had an inadequate response to conventional antihistamine doses. Twenty patients with Urticaria Activity Score over 7 days (UAS7) ≥16 and D-dimer >500 ng/mL were randomized to receive either antiplatelet therapy (cilostazol 150 mg/day + dipyridamole 50 mg/day) with antihistamine (desloratadine 20 mg/day) or antihistamine alone for 4 weeks. The antiplatelet group demonstrated a greater decrease in UAS7 compared to the control group (28.10 to 8.90 vs. 22.90 to 16.40, p < 0.001 vs. p = 0.054). Both groups experienced improved quality of life (DLQI), but the improvement was greater in the antiplatelet group (p = 0.046). D-dimer levels decreased only in the antiplatelet group (1133.67 ng/mL to 581.89 ng/mL, p = 0.013) with no significant change observed in the control group. This suggests that combining dipyridamole and cilostazol with up-dosing antihistamines may be more effective for CSU patients with high D-dimer levels compared to up-dosing antihistamines alone. This could be due to a reduction in platelet activation, as evidenced by the decrease in D-dimer levels observed in the antiplatelet group.<br /> (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Subjects :
- Adult
Female
Humans
Male
Middle Aged
Double-Blind Method
Histamine Antagonists administration & dosage
Histamine Antagonists therapeutic use
Quality of Life
Tetrazoles administration & dosage
Tetrazoles therapeutic use
Treatment Outcome
Chronic Urticaria drug therapy
Cilostazol administration & dosage
Cilostazol therapeutic use
Dipyridamole administration & dosage
Dipyridamole therapeutic use
Drug Therapy, Combination
Fibrin Fibrinogen Degradation Products metabolism
Fibrin Fibrinogen Degradation Products analysis
Loratadine administration & dosage
Loratadine therapeutic use
Loratadine analogs & derivatives
Platelet Aggregation Inhibitors administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1600-0625
- Volume :
- 33
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Experimental dermatology
- Publication Type :
- Academic Journal
- Accession number :
- 39175304
- Full Text :
- https://doi.org/10.1111/exd.15168