A Hospital Based Comparative Study to Evaluate the Efficacy of Methotrexate v/s Dapsone/ASST for Treatment of Chronic Urticaria

Abstract

Background: Chronic Urticaria remains a major problem in terms of etiology, investigation, and management and causes comorbidity and high cost to the health care system. In our study, we are comparing the use of ASST, Dapsone and Methotrexate for the treatment of resistant chronic urticaria. So, these study findings will play an important role to determine treatment protocols for patients with chronic urticaria. Materials & Methods: A prospective comparative study done on 100 patients with chronic urticaria were selected from the patients attending out-patient clinic in Department of Dermatology, S.K. Government Medical College, Sikar, Rajasthan, India. The patients will be randomly allotted to any one of the following four treatment groups after calculating their Urticarial Activity Score (UAS) & Dermatology Life Quality Index (DLQI). Group A (Dapsone 50 mg), Group B (Methotrexate 10 mg), Group C (ASST) & control group. Patients were then divided into three categories based on these parameters into Good Responders, Average Responders & Poor Responders. Results: More than 76% of patients treated with ASST had good response to treatment while only 52% of those treated with dapsone and 32% of those treated with methotrexate had good response to treatment. Poor response was seen in 4% of ASST and Dapsone patients compared to the 20% in patients receiving Methotrexate. This is still better than the 60% with poor response in the control group. Side effects were more common in patients taking methotrexate with 3 out of 25 patients experiencing minor side effects while two patients taking dapsone also had documented side effects. Conclusion: Managing cases of urticaria has always been an challenging issue. Various treatment modalities are available for treating recalcitrant cases of urticaria. We concluded that ASST can be considered as a first line of treatment, Dapsone can be considered for patients refractory to treatment and Methotrexate is recommended as last resort, in patients who are refractory to other modalities of treatment.