Urticaria- Hold the Prednisone

June 21, 2017

No prednisone for urticaria
Adding 4 days of prednisone 40mg daily to an H1 blocker (levocetirizine) didn’t help patients with urticaria.  Itching and recurrence of lesions was unchanged in the prednisone group.  In light of recent evidence that even short-course steroids may be associated with harm, this study may help avoid unhelpful glucocorticoid use for patients with straightforward urticaria.  Keep in mind, patients with severe allergic reaction, anaphylaxis, or angioedema were excluded.

Spoon Feed
Prednisone 40mg daily x 4 days was not helpful in reducing itching in patients with simple urticaria.  JWatch has a free summary.

Source
Levocetirizine and Prednisone Are Not Superior to Levocetirizine Alone for the Treatment of Acute Urticaria: A Randomized Double-Blind Clinical Trial.  Ann Emerg Med. 2017 May 2. pii: S0196-0644(17)30264-0. doi: 10.1016/j.annemergmed.2017.03.006. [Epub ahead of print]

Written by Clay Smith.  Peer reviewed by Thomas Davis.