Study of effectiveness of methotrexate oral pulse in refractory chronic urticaria

Abstract

Chronic urticaria (CU) is an unexplained problem that needs to be addressed, and since patients also experience the morbidity associated with irritable itch, they must take a significant quantum of antihistamines. Autoantibodies in the blood cause recurrent flare-ups in autoreactive urticaria when the symptoms are more noticeable. As a result, the need for an adjuvant drug to lessen the weight of pills is felt. The aim of this study was to find out the effectiveness of oral methotrexate (MTX) pulse with antihistamines in chronic refractory urticaria. This was the present longitudinal intervention. The study lasted six months and was carried out at the Department of Dermatology in a hospital with tertiary care status. Fifty patients of chronic spontaneous urticaria have been selected by simple random sampling. All subjects have been given Oral Methotrexate, 15 mg once weekly along with folic acid. Besides, MTX all cases have been given oral desloratadine 5 mg twice daily. Most patients have seen a significant decline in urticaria activity score 7 (UAS7) and dermatological life quality index. The baseline mean UAS7 reduced significantly from 30.16 ± 8.65 to 1.24 ± 2.24 with a statistically significant P < 0.01. No serious side effects were seen except mildly raised liver transaminases in seven patients. When standard second-generation antihistamines are insufficient at treating chronic uncontrolled urticaria, MTX is a very safe, well-tolerated, and economical treatment option.