Table 3.
Anecdotal case and open series: chronic urticaria (CU) treated with antileukotrienes
| Type of CU | Patients treated | Drugs | Results | Outcome | Study | Category of evidence | Grade of recommendation | Reference |
|---|---|---|---|---|---|---|---|---|
| Severe CU with ASA intolerance | 1 | zafirlukast 20 mg twice daily vs zileuton 600 mg 4 times daily | zileuton better than zafirlukast | Favorable | NA | III | D | 24 |
| Severe CU with ASA intolerance | 1 | zileuton 600 mg 4 times daily | Marked improvement | Favorable | NA | III | D | 24 |
| NSAID-induced exacerbation of CU | 1 | montelukast 10 mg once a day | Complete resolution of urticaria but relapse after a single dose of oral piroxicam | Favorable | NA | III | D | 25 |
| NSAID-induced exacerbation of CU | 1 | zafirlukast 20 mg twice daily | Complete resolution of urticaria without relapse after a course of injected piroxicam | Favorable | NA | III | D | 25 |
| Chronic autoimmune urticaria | 1 | montelukast 10 mg once a day | Improvemrnt of CU | Favorable | NA | III | D | 26 |
| Cold urticaria refractory to H1-antihistamine | 1 | montelukast 10 mg once a day | Improvemrnt of cold urticaria | Favorable | NA | III | D | 27 |
| Acquired cold urticaria | 2 | zafirlukast 20 mg twice daily vs cetirizine 10 mg once a day vs zafirlukast plus cetirizine | Combination therapy (zafirlukast plus cetirizine) better than monotherapy | Favorable | NA | III | D | 28 |
| Delayed pressure urticaria | 1 | montelukast 10 mg a day | Symptom-free under treatment but discontinuation not possible | Favorable | NA | III | D | 29 |
| Intractable CU | 1 | zafirlukast 20 mg twice daily | Remission of symptoms | Favorable | NA | III | D | 30 |
| Intractable CU | 1 | zileuton 600 mg 4 times daily | Remission of symptoms | Favorable | NA | III | D | 30 |
| ASA-induced urticaria | 2 | pranlukast 112.5 mg once a day | Relapse of urticaria | Unfavorable | NA | III | D | 31 |
| Delayed pressure urticaria | 20 | loratadine 10 mg once a day alone vs loratadine 10 mg once a day plus montelukast 10 mg once a day | Combination therapy (loratadine plus montelukast) better than loratadine alone | Favorable | No reported the randomized | IIb | C | 32 |
| Steroid-dependent chronic idiopathic urticaria | 15 | montelukast 10 mg once a day, zafirlukast 20 mg twice daily | Improvement in some patients | Favorable | No RTC | IIb | C | 33 |
| Unremitting steroid-dependent urticaria | 12 | montelukast 10 mg once a day, zafirlukast 20 mg twice daily | Nearly total remission in some of the patients | Favorable | No RTC | IIb | C | 34 |
| Chronic idiopathic | 6 | Zafirlukast 20 mg twice daily | Marked improvement | Favorable | No RTC | IIb | C | 35 |
| Dermographism | 2 | Zafirlukast 20 mg twice daily | Marked improvement | Favorable | No RTC | IIb | C | 35 |
| Allergic urticaria | 7 | Zafirlukast 20 mg twice daily | Less benefit | Uncertain | No RTC | IIb | C | 35 |
| Chronic idiopathic | 7 | montelukast 10 mg once a day, zafirlukast 20 mg twice daily | Marked improvement | Favorable | No RTC | IIb | C | 36 |
| Chronic idiopathic urticaria (majority of patients with positive ASST) | 27 | Montelukast 10 mg once a day vs fexofenadine 180 mg once a day | Montelukast had better therapeutic effects compared to fexofenadine | Favorable | No RTC | III | D | 37 |
| COX-2 selective inhibitors exacerbation of CU | 1 | montelukast 10 mg once a day | Marked improvement | Favorable | NA | III | D | 38 |
| ASA and NSAID-induced exacerbation of CU | 25 | montelukast 10 mg once a day | Marked improvement in 22 patients | Favorable | No RTC | III | D | 39 |
| Chronic idiopathic | 20 | montelukast 10 mg once a day or cetirizine 10 mg once a day | Cetirizine better of montelukast monotherapy | Unfavorable | Randomized without placebo | III | D | 40 |