Abstract

Background: H1-antihistamines are the first-line treatment of chronic idiopathic urticaria (CIU), but CIU is occasionally refractory to the conventional treatment doses. Guidelines in Europe recommend increasing doses as second-line therapy; however, more supportive evidences for these guidelines are required to justify this management strategy. Methods: In this study, the authors evaluated the effect of conventional and double doses of fexofenadine HCl on CIU and on histamine-induced skin responses by iontophoresis using visual and laser Doppler imaging scales in healthy donors. Results: Cutaneous manifestations in CIU and histamine-induced flare and itch in healthy donors were attenuated more extensively by a double dose of fexofenadine HCl compared with a conventional dose. Conclusion: The above findings support the management strategy that increasing the dose of non-sedative antihistamines is the second-line treatment choice for refractory CIU even in Japanese populations.

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