Loratadine and cetirizine in the treatment of chronic urticaria

Aim This study was designed to compare loratadine and cetirizine in controlling the symptoms of chronic urticaria. Subjects One hundred and sixteen adult patients with chronic urticaria. Methods In this double-blind study the patients were randomly divided into three therapeutic groups: 38 received loratadine (10 mg), 40 cetirizine (10 mg) and 38 placebo tablets once daily for 28 days. Steroid-dependent subjects and patients with physical urticaria or with angioneurotic hereditary oedema as well as pregnant or breast-feeding women were excluded from the study. A suitable wash-out period was observed in case of previous treatments for the same disease. Itching, erythema, number of lesions and diameter of the largest one were evaluated according to a scale from 0 (absent) to 3 (severe). The minimum entry study score for itching plus number of lesions had to be at least equal to three. Control visits were scheduled after 3, 7 and 14 days of therapy. Symptoms, disease status, therapeutic response, side effects and compliance were evaluated at each visit. Diary cards were filled in by patients at home. Results Active drugs compared to placebo significantly reduced global clinical symptoms (P <0.05). Loratadine was more rapid in developing its activity than the other two agents (P <0.01 at day 3). Each single symptom showed the same trend. At the end of the study 24 (63%) patients treated with loratadine, 18 (45%) with cetirizine and 5 (13%) with placebo were free from symptoms. Four failures occurred with loratadine, six with cetirizine and seventeen with placebo. The tolerability profile was similar for all three groups. One patient receiving cetirizine dropped out due to severe gastric pain. Conclusions Loratadine is more active and safer than cetirizine in the treatment of chronic urticaria.