Published: 2019-06-24

Efficacy of Levocetirizine, Prednisolone and their combination in the treatment of chronic urticaria: a comparative study

Kanhaiah More, B. Samskar, G. B. Simpson


Background: Urticaria results from many different stimuli and numerous factors like immunologic, non-immunologic, genetic and modulating factors which are involved in its pathogenesis and ultimately converge on mast cells and basophils to release mediators and produce urticarial lesions. This study is aimed to compare the therapeutic effectiveness of Levocetirizine (newer generation H1 blocker), prednisolone (glucocorticoid) and their combination in the treatment of chronic urticaria.

Methods: Group I (34 patients received tab Levocetirizine alone 5mg daily for 15 days). Group II (33 patients received tab Prednisolone alone 20mg /day for initial 3 days and later dose was gradually tapered by 5mg /day every 3 days to 5mg/day with total duration of 12 days). Group III (33 patients received the combination of Levocetirizine and Prednisolone).

Results: The Group -I patients average eosinophil count before and after treatment was 4±1.4 and 2.4±0.8 respectively, with an average difference of 1.7±1.3. In Group - II patients average eosinophil count before and after treatment was 4.0±1.1 and 2.5±0.3 respectively, with an average difference of 1.5±1.1. In the Group - III patients the average eosinophil count before and after treatment was 4.3±1.0 and 2.1±1.0 with an average difference of 2.2±1.3. In G-I (n=34).

Conclusions: Statistical analysis of the present study showed that the combination of Levocetirizine and prednisolone therapy was significantly (P<0.05) greater than prednisolone alone therapy and improvement with Levocetirizine alone (79%) was almost similar to combination therapy (85%).


Antihistamine, Chronic urticaria, Levocetirizine, Prednisolone

Full Text:



Asero R. Chronic idiopathic urticaria: a family study. Ann Allergy Asthma Immunol. 2002 Aug 1;89(2):195-6.

Fusari A, Colangelo C, Bonifazi F, Antonicelli L. The autologous serum skin test in the follow‐up of patients with chronic urticaria. Allergy. 2005;60(2):256-8.

Mahesh PA, Kushalappa PA, Holla AD, Vedanthan PK. House dust mite sensitivity is a factor in chronic urticaria. Indian J Dermatol Venereol Leprol. 2005 Mar 1;71(2):99.

Monroe EW, Jones HE. Urticaria. An updated review. Arch Dermatol. 1977;113:80-90.

Black KA, Champion RH. Urticaria. Chapter 47 in Rook, Wilkinson and Ebling. Textbook of Dermatology. Champion RH et al. 6th Ed. London:Black well science. 1998;3:2113-2134.

Sibbald RG, Cheema AS, Lozinski A, Tarlo S. Chronic urticaria: evaluation of the role of physical, immunologic, and other contributory factors. Int J Dermatol. 1991 Jun;30(6):381-6.

Greaves MW. Chronic urticaria. N Eng J Med. 1995 Jun 29;332(26):1767-72.

Monroe EW. Chronic urticaria: review of nonsedating H1 antihistamines in treatment. Journal of the Am Academy Dermatol. 1988 Nov 1;19(5):842-9.

Singh-Franco D, Ghin HL, Robles GI, Borja-Hart N, Perez A. Levocetirizine for the treatment of allergic rhinitis and chronic idiopathic urticaria in adults and children. Clin therapeu. 2009 Aug 1;31(8):1664-87.

Odom RB, James WD, Berger TG. Erythema and Urticaria. Chapter 7. In: Andrew's Diseases of the Skin. Clinical Dermatology. 9th Ed. Philadelphia: W.B. Saunders Company;2000:160-171.

Chrousos GP. Adrenocorticosteroids and Adrenocortical Antagonists. Chapter 39. In: Bertram G. Katzung, Basic and Clinical Pharmocology. 10th Ed. New York:McGraw- Hill;2007:660-678.

Rose B. Studies on blood histamine in cases of allergy: I. Blood histamine during wheal formation. Journal of Allergy. 1941 May 1;12(4):327-34.

Breathnach SM, Allen R, Ward AM, Greaves MW. Symptomatic dermographism: Natural history, clinical features, laboratory investigations and response to therapy. Clin Experiment Dermatol. 1983 Sep;8(5):463-76.

Atthews CN, Kirby JD, James J, Warin RP. Dermographism: reduction in weal size by chlorpheniramine and hydroxyzine. Br J Dermatol. 1973 Mar;88(3):279-82.

Kaplan AP, Gray L, Shaff RE, Horakova Z, Beaven MA. In vivo studies of mediator release in cold urticaria and cholinergic urticaria. J Allergy Clin Immunol. 1975 Jun 1;55(6):394-402.

Johnston WE, Moss J, Philbin DM, Guiney TE, Sisson JH, Buckley Jr MJ, et al. Management of cold urticaria during hypothermic cardiopulmonary bypass. N Eng J Med. 1982 Jan 28;306(4):219-21.

Wasserman SI, Austen KF, Soter NA. The functional and physicochemical characterization of three eosinophilotactic activities released into the circulation by cold challenge of patients with cold urticaria. Clin Exp Immunol. 1982 Mar;47(3):570-8.

Sigler RW, Evans III R, Horakova Z, Ottesen E, Kaplan AP. The role of cyproheptadine in the treatment of cold urticaria. J Allergy Clin Immunol. 1980 Apr 1;65(4):309-12.