Successful Treatment of Chronic Idiopathic Urticaria and Angioedema with 5-Aminosalicylic Acid

Abstract

RATIONALE: Urticaria is a common condition that affects as many as 25% of people at some time during their lives. Chronic recurrent urticaria and angioedema can be frustrating and often refractory to conventional treatment. The purpose of this study was to evaluate the efficacy of 5-aminosalicylic acid in the treatment of unremitting recurrent urticaria and angioedema.METHODS: We performed a retrospective chart review of nine chronic idiopathic urticaria/angioedema (CIU) patients treated with 5-aminosalicylic acid (5-ASA) as adjunctive therapy at the Winnipeg Health Science Centre from 2006 to 2008. We recorded demographic data, response to 5-ASA, presence of autoimmunity and/or the IgE receptor antibody, steroid use and side effects.RESULTS: The patients' ages ranged between 16-61 years with four patients(44%) being female. Seven patients (77.8%) had either a personal history of hypothyroidism (4/9), hyperthyroidism (1/9) or a first degree relative with hypothyroidism (2/9). 22% of patients were found to have an IgE receptor antibody, one of whom had hypothyroidism and the other hyperthyroidism. Five patients (55.6%) showed complete response, two (22%) had partial response and two (22%) failed to respond to 5-ASA adjunctive therapy. Only two patients required occasional use of prednisone. The only side effect noted was constipation in one patient.CONCLUSIONS: 5-aminosalicylic acid is an effective adjunctive therapy for patients with CIU, resulting in partial or total remission of symptoms in 77.8% of patients. Blinded, placebo controlled trials are required to confirm its efficacy. RATIONALE: Urticaria is a common condition that affects as many as 25% of people at some time during their lives. Chronic recurrent urticaria and angioedema can be frustrating and often refractory to conventional treatment. The purpose of this study was to evaluate the efficacy of 5-aminosalicylic acid in the treatment of unremitting recurrent urticaria and angioedema. METHODS: We performed a retrospective chart review of nine chronic idiopathic urticaria/angioedema (CIU) patients treated with 5-aminosalicylic acid (5-ASA) as adjunctive therapy at the Winnipeg Health Science Centre from 2006 to 2008. We recorded demographic data, response to 5-ASA, presence of autoimmunity and/or the IgE receptor antibody, steroid use and side effects. RESULTS: The patients' ages ranged between 16-61 years with four patients(44%) being female. Seven patients (77.8%) had either a personal history of hypothyroidism (4/9), hyperthyroidism (1/9) or a first degree relative with hypothyroidism (2/9). 22% of patients were found to have an IgE receptor antibody, one of whom had hypothyroidism and the other hyperthyroidism. Five patients (55.6%) showed complete response, two (22%) had partial response and two (22%) failed to respond to 5-ASA adjunctive therapy. Only two patients required occasional use of prednisone. The only side effect noted was constipation in one patient. CONCLUSIONS: 5-aminosalicylic acid is an effective adjunctive therapy for patients with CIU, resulting in partial or total remission of symptoms in 77.8% of patients. Blinded, placebo controlled trials are required to confirm its efficacy.