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Efficacy of Atorvastatin and Antihistamines in Comparison with Antihistamines plus Placebo in the Treatment of Chronic Idiopathic Urticaria: A Controlled Clinical Trial

Abstract

Chronic Idiopathic Urticaria is defined as recurrent hives occurring for at least 6 weeks. In  the  majority of  cases, there  is no  identifiable underlying etiology despite  extensive evaluation. A subset of these patients is classified as having autoimmune urticaria defined by the presence of a functional IgG antibody to the α subunit of the high-affinity IgE receptor (FceRIa) or to IgE. The aim of this study was to evaluate the effects of the drug atorvastatin in patients with chronic urticaria compared to the placebo.
In this single-blind study, 50 patients suffering from chronic urticaria (15-45 years old) were selected and divided into two groups by simple randomization method. The first group was treated with atorvastatin and antihistamines and the second group (control group) was treated with placebo and antihistamines for 3 months. Urticaria severity was measured by score index, before and after the treatment course: ASST (Autologous serum skin test) was performed for all patients and sera were collected to measure cytokines.
In cases, IL-5 decreased and IL-10 increased after treatment compared to the time point before  treatment  (p<0.05). All patients with severe utricaria according our  scoring, had positive ASST.
The patients with severe urticaria identified by urticaria score and ASST positivity had chronic idiopathic urticaria. By prescribing the Atorvastatin plus antihistamines in severe and resistant forms of urticaria, the use of more toxic medications like cytotoxic drugs may be avoided.

1. Adkinson NF Busse, WW Bochner, B.S. et al. (editors). (2009) Middletons Allergy:Principles and Practice.7th ed. Mosby, St. Louis, MO.
2. Riboldi P, Asero R, Tedeschi A, Gerosa M, Meroni PL.Chronic Urticaria: New immunologic aspects. Isr Med Assoc J 2002; 4(11):872-3
3. Szegedi A, Irinyi B, Gál M, Hunyadi J, Dankó K, Kiss E, et al. Significant correlation between the CD63 assay and the histamine release assay in chronic urticaria. Br J Dematol 2006; 155(1):67-75.
4. Marsland AM. Autoimmunity and complement in the pathogenesis of chronic urticaria. Curr Allergy Asthma Rep 2006; 6 (4):265-9.
5. Sabroe RA, Greaves MW. Chronic idiopathic urticaria with fuvctional autoantibodies: 12 years on. Br j Dermatol 2006; 154(5):813-9.
6. Sheikh J. Autoantibodies to the high-affinity IgE receptor in chronic urticaria:How important are they? Curr Opin Allergy Clin Immunol 2005; 5 (5):403-7.
7. Lock C. Are ”statins” beneficial or harmful in multiple sclerosis? Neurology 2008; 71(18):e54-5.
8. Vollmer T, Key L, Durkalski V, Tyor W, Corboy J,Markovic-Plese S, Preiningerova J, Rizzo M, Singh I. Oral simvastatin treatment in relapsing-remitting multiple sclerosis. Lancet 2004; 15; 363(9421):1607-8.
9. Neves PL, Malho A, Cabrita A, Pinho A, Baptista A, Morgado E, et al. Statins and vitamin D: A friendly associan in pre-dialysis patients. Int Urol Nephrol 2010;42(1):173-9.
10. Rotta M, Storer BE, Storb RF, Martin PJ, Heimfeld S, Peffer A, et al. Donor statin treatment protects against severe acute graft-versus-host disease after related allogeneic hematopoietic cell transplantation. Blood 2010;115(6):1288-95.
11. Majlesi Y, Samorapoompichit P, Hauswirth AW, Schernthaner GH, Ghannadan M, Baghestanian M, et al. Dependent differentiation and IgE-mediated histamine basophils and downmodulate expression of the basophil- Activation antigen CD203c/E-NPP3. J Leukoc Biol 2003;73(1):107-17.
12. Krauth MT, Majlesi Y, Sonneck K, Samorapoompichit P, Ghannadan M, Hauswirth AW, et al. Effect of various statins on cytokines-dependent growth and IgE-dependent release of histamine in human mast cells. Allergy 2006;61(3):281-8.
13. Bessler H, Salman H, Bergman M, Straussberg R, Djaldetti M. In vitro effect of statins on cytokine production and mitogen response of human peripheral blood mononuclear cells. Clin Immunol 2005; 117(1):73-7.
14. Xiaoming L , Wanxiang S, Khalaf A, Jiquan S, Jinquan T. Relation between Autoimmunity Chronic Urticaria and the levels of plasma prothrombin. American Journal of Applied Sciences 2007; 4(12):965-9.
15. Tirnaksiz E, Pamukcu B, Oflaz H, Nisanci Y. Effect of dose statin therapy on platelet function;statins reduce aspirin-resistant platelet aggregation in patients with coronary heart disease. J Thromb Thrombolysis 2009; 27(1):24-8.

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IssueVol 11, No 3 (2012) QRcode
SectionArticles
Keywords
Atorvastatin Chronic Idiopathic Urticaria Cytokines
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1.
Pezeshkpoor F, Farid Hosseini R, Rafatpanah H, Shakerian B, Jabbari F, Zandkarimi MR, Yousefzadeh H, Sadri H, Bahrami A, Zamani MA. Efficacy of Atorvastatin and Antihistamines in Comparison with Antihistamines plus Placebo in the Treatment of Chronic Idiopathic Urticaria: A Controlled Clinical Trial. Iran J Allergy Asthma Immunol. 1;11(3):236-240.