High occurrence of antihistamine resistance in patients with recurrent idiopathic angioedema

• Letter to the Editor
• Open Access 
Clinical and Translational Allergy

• Zonne L. M. HofmanView ORCID ID profile,
• Nikki van West,
• C. Erik Hack,
• André C. Knulst,
• Coen MaasView ORCID ID profile and
• Heike RöckmannEmail author

Clinical and Translational Allergy20199:35

https://doi.org/10.1186/s13601-019-0274-7

Abstract

Antihistamines are the most prescribed therapy in recurrent idiopathic angioedema, yet little is known about their efficacy. Herein, we report on clinical improvement with antihistamine therapy in 120 patients evaluating angioedema attack frequency. A high incidence (36%) of antihistamine refractory cases was observed.

Attack frequency in relation to antihistamine prophylaxis. Attack frequencies were evaluated at maximum antihistamine dose prescribed (prior to add-on therapy) a box-and-whiskers-plot of attack frequency at first visit (V1) and follow-up (FU) with (+),or without intervention (−), bold line = median, Mann–Whitney and Wilcoxon test were used comparing groups respectively paired samples. b Percentage of patients reporting improvement per maximum dose antihistamines prescribed, improvement was defined as shift into a lower attack frequency group, n = total patients per group, patients with missing data on attack frequency could not be evaluated for improvement (n = 25). c Attack frequency per maximum dose prescribed

Forty percent of patients on antihistamine prophylaxis suffered from 1 or more angioedema attacks per month. Our findings stress the need for additional treatment options for recurrent idiopathic angioedema.

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