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. 2024 Jun 26;15(4):630-633.
doi: 10.4103/idoj.idoj_703_23. eCollection 2024 Jul-Aug.

Clinico-Epidemiologic Profile and Response to Levocetirizine in Chronic Spontaneous Urticaria: A Retrospective Cohort Study from a Tertiary Care Center in North India

Raihan Ashraf  1 , Anuradha Bishnoi  1 , Hitaishi Mehta  1 , Davinder Parsad  1 , Muthu Sendhil Kumaran  1
Affiliations

Clinico-Epidemiologic Profile and Response to Levocetirizine in Chronic Spontaneous Urticaria: A Retrospective Cohort Study from a Tertiary Care Center in North India

Raihan Ashraf et al. Indian Dermatol Online J. .

Abstract

Background: Comprehensive long-term follow-up data regarding chronic spontaneous urticaria (CSU) among general populations, especially from the Indian subcontinent is scanty.

Aim and objectives: The aim of the study were to analyze the clinico-epidemiological profile, comorbidities of CSU patients, and factors affecting patient response to various doses of levocetirizine.

Materials and methods: In this retrospective cohort study, complete history regarding demographic profile, clinical examination, investigations, treatment given, and follow-up details of all CSU patients attending urticaria clinic between 2010 and 2019 were analyzed. These were considered variables to determine the factors playing a role in response to various doses of levocetirizine.

Results: Totally, 1104 files of CSU were analyzed. The male-to-female ratio was 1:1.5 with a mean age of 33.03 ± 14.33 years. Thyroid dysfunction and atopy were seen in 142 (12.8%) and 184 (16.7%) patients, respectively. Vitamin D deficiency and high serum immunoglobulin E (IgE) levels were seen in 461 (41.7%) and 340 (30.7%) patients, respectively. Immunosuppressives were required at some point in 196 (17.7%) patients. Patients with higher levels of serum IgE and D-dimer (P < 0.05) were found to require frequent updosing of levocetirizine, while age, sex, duration of illness, presence of angioedema, co-morbidities, identifiable precipitating factors, presence of diurnal variation, family history, and vitamin D deficiency were found to not have an effect on levocetirizine dosing.

Conclusion: Ours is a large single-center study exemplifying the biomarkers including baseline serum IgE and D-dimer levels, which could identify a CSU patient who could warrant a higher dose of antihistamine/antihistamine refractory urticaria.

Keywords: Angioedema; D-dimer; antihistamines; chronic spontaneous urticaria; immunosuppressives.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Clustered column chart showing the relationship between serum D-dimer levels and response to levocetirizine
Figure 2
Figure 2
Clustered column chart showing the relationship between serum immunoglobin E levels and response to levocetirizine
See this image and copyright information in PMC

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