Cyclosporine in chronic idiopathic urticaria: a double-blind, randomized, placebo-controlled trial

Treatment of severe recalcitrant chronic idiopathic urticaria (CIU) is difficult.

To assess the efficacy and safety of oral cyclosporin A (CsA) in CIU.

The response to CsA was evaluated in 99 CIU patients with a double-blind, randomized, three-armed study: 16-week CsA, 8-week CsA +8-week placebo, and 16-week placebo. All patients received cetirizine throughout the study period and were followed-up after 8 weeks.

Fewer therapeutic failures occurred with 16-week CsA (n = 3) than with placebo (n = 11) and 8-week CsA (n = 8). After 8 and 16 weeks, symptom scores significantly improved in both CsA groups over with placebo. Two patients discontinued because of hypertension.

During the study period, CsA was not administered at a constant dose; from day 28 the daily dose was 3 mg/kg, which is likely to be less effective and better tolerated than higher dosages.

CsA in addition to background therapy with cetirizine may be useful in the treatment of CIU.