Do Corticosteroids Help To Relieve Symptoms of Acute Urticaria?

Corticosteroids do not benefit patients presenting to the emergency department with acute urticaria, according to a recent trial. 

In a double-blind, randomized clinical trial, researchers evaluated the effects of a 4-day course of prednisone added to antihistamine therapy for the treatment of acute urticaria. The trial involved 100 participants given levocetirizine (5 mg orally for 5 days), 50 of whom also received prednisone (40 mg orally for 4 days) and 50 of whom also received placebo. Patients were eligible for inclusion if they had not received antihistamines or glucocorticoids in the past 5 days, and were not anaphylactic. 
______________________________________________________________________________________________________________________________________________________________
RELATED CONTENT
Vitamin D Benefits Patients with Chronic Hives
Urticaria Secondary to Monoethanolamine Sensitivity
______________________________________________________________________________________________________________________________________________________________

Overall, 7 participants in the prednisone group and 8 in the placebo group discontinued treatment. At 2-day follow-up, 62% of those in the prednisone group had an itch score of 0, compared with 76% of those in the placebo group, and 30% in the prednisone group reported relapse, compared with 24% in the placebo group.

“The addition of a prednisone burst did not improve the symptomatic and clinical response of acute urticaria to levocetirizine. This study does not support the addition of corticosteroid to H1 antihistamine as first-line treatment of acute urticaria without angioedema.”

—Michael Potts

Reference:

Barniol C, Dehours E, Mallet J, et al. Levocetirizine and prednisone are not superior to levocetirizine alone for the treatment of acute urticaria: a randomized double-blind clinical trial [published online May 3, 2017]. Ann Emer Med. doi: dx.doi.org/10.1016/j.annemergmed.2017.03.006.