The impact of high-dose desloratadine in treating chronic idiopathic Urticaria in Libyan patients

Chronic idiopathic urticaria it`s a transient vascular reaction pattern characterized by short-lived circumscribed erythematous, edematous and itchy wheals usually lasting for a few hours to few days for a period of at least six weeks without an identifiable causes and its negative influence on the quality of life. It's a disabling affliction that considerably limits patients' daily activities. Desloratadine is a long-acting tricyclic histamine antagonist with selective H1-receptor. and possesses anti-allergic and anti-inflammatory activity. Desloratadine was administrated in conventional and in up to 4 times conventional doses which is recommended by the current European Academy of Allergology and Immunology regarding desloratadine high-doses. Objective: To evaluate the effectiveness of desloratadine at high in the treatment of chronic idiopathic urticaria and to provide supportive evidence for the European guidelines regarding high dose desloratadine. Methodology: In this study was conducted in 36 Libyan patients, all patients with a diagnosis of chronic idiopathic urticaria. The patients were investigated and examined to rule out any cause. Our patients were divided in three groups12 patients in each group ;( A) Started at the conventional daily dose of 5mg oral desloratadine every day for 20 days. (B) received higher dose of 10 mg and (C) administrated up to 4 times conventional doses (20 mg daily), which is recommended by the current European Academy of Allergology and Immunology. Result: All our patients that enrolled in this study has chronic idiopathic urticaria, Patients achieved complete treatment during time period of 20 days, our patients received oral desloratadine in differed doses (5, 10, or 20 mg) every day for 20 days. In this prospective study included 36 patients with Chronic idiopathic urticaria were divided in three groups; in-group (A) 4 of 12 patients became symptom-free with 5 mg of desloratadine. in-group (B) 7 of 12 patients became symptom-free at 10 mg of desloratadine and in-group(C) patients administered higher dose at 20 mg daily and were showed great responses, in 9 of 12 patients becomes symptom-free. Conclusion Increasing the dosage of desloratadine up to 4-fold is significantly improve chronic urticaria symptoms and quality of life without compromising safety in approximately about three quarters of patients. and increase desloratadine dosing might benefit patients with Chronic idiopathic urticaria who do not respond to standard dose.