Role of cyproheptadine in chronic urticaria not controlled with second-generation antihistamines: a retrospective study

Abstract

Aim:This retrospective study was performed to evaluate the efficacy and tolerability of cyproheptadine versus montelukast as adjuncts to ongoing second-generation antihistamines in adults with refractory chronic urticaria.

Methods:This study included adult patients diagnosed with chronic urticaria who did not respond to standard treatment, divided into two groups. Group A received antihistamines plus oral cyproheptadine for one month, and group B received antihistamines in addition to standard-dose montelukast daily (10 mg) for four months. The weekly urticaria activity score (UAS7), chronic urticaria quality of life questionnaire (CU-Q₂oL), and dermatology life quality index (DLQI) scores were measured at the end of grading after four months.

Results:After four months, both groups showed significant improvements in UAS7 and CU-Q₂oL scores, and group A also saw a notable increase in DLQI score compared to baseline. Group A showed more pronounced improvements overall. Both groups saw a reduction in background antihistamine usage, with group A experiencing a more significant decrease. Additionally, more patients in group A reported daytime sedation and weight gain compared to group B.

Conclusions:Cyproheptadine, along with second-generation antihistamines, was found to be efficacious and safe as compared to montelukast along with second-generation antihistamines in patients with chronic urticaria.

Keywords

cyproheptadine / chronic urticaria / montelukast / antihistamines

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