Efficacy of Montelukast and Ranitidine as an Add on Therapy for Chronic Urticaria

Background: Chronic urticaria is a highly distressing disease affecting a person's quality of life. In most cases, monotherapy fails. Hence, combinations of antihistamines with montelukast, H2 blockers, ciclosporin, dapsone, omalizumab are used with varying results. This study was done to assess the efficacy and safety of the combination therapy of Montelukast and Cetirizine with Ranitidine and Cetirizine in chronic urticaria patients. Methodology: In this randomized controlled study, hundred patients were recruited, randomized and medications were given to group A (Cetirizine + Montelukast) and group B (Cetirizine + Ranitidine). Complete history, clinical examination and laboratory investigations were done at the beginning of the study. Patients were educated to keep a daily record of Urticaria Activity Score (UAS7) over seven consecutive days in a descriptive chart. Review of patient's UAS7 record and clinical examination were done at every weekend. Sum of score at the end of every week for 4 weeks were calculated and recorded. Results: The mean weekly UAS in group A were 18.67, 10.07, 4.65, and 1.74 and in group B were 27.77, 19.38, 13.68 and 8.04 respectively. Significant difference in symptom reduction between group A and group B was found to be favouring group A. The mean total UAS in group A was 35.13, group B is 68.87 (p < 0.001). Conclusion: Montelukast seems to be a promising medication as add-on therapy to Cetirizine both in the aspect of efficacy and safety in patients affected by chronic urticaria.