Corticosteroids

The addition of oral prednisone 20 mg twice daily for 4 days to the standard treatment with H1 antagonists was investigated in 43 adults by Pollack and Romano10 The intensity of itch, as scored on a VAS, was significantly reduced by both regimens after 2 and 5 days of follow up. However, the addition of prednisone reduced the symptom score significantly more than the standard therapy. Although, standard therapy with antihistamines is generally considered sufficient, in selected cases (severity, need to shorten antihistamines) addition of prednisone seems helpful.

Similar, Zuberbier et al. showed that prednisolone 50 mg/day for 3 days led to a significantly higher clearing rate (93-8%) after days than therapy with loratadine 10 mg/day in 109 patients.2 The study may be limited by aspects of design (open, pseudo-randomisation by consecutive time periods, differential allocation of possibly pregnant women).

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