Steroids in children with acute urticaria
| Citation | Study group | Study type (level of evidence) | Outcome | Key result | Comments |
|---|---|---|---|---|---|
| Pollack et al (1995) | 43 adult outpatients with acute urticaria given i.m. diphenhydramine then randomised to oral hydroxyzine plus either 20 mg prednisone 12 hourly for 4 days or placebo | RCT (level 1b) | 10 point visual analogue itch score at 48 hours. Itch score at 5 days. Description of rash at 48 hours and 5 days | Mean 48 hour itch score 1.3 in prednisone group v 4.4 in control group. 5 day itch score 0 in prednisone group v 1.6 in control group. No difference between groups at 48 hours. Rash resolved completely at 5 days in prednisone group | Adult patients only. Small study, no power calculation. Rash not described at 5 days in control group |
| Zuberbier et al (1996) | 109 adult and paediatric patients with acute urticaria treated with loratidine 10 mg daily or prednisolone 50 mg daily for 3 days followed by loratidine 10 mg daily until remission of symptoms | Non-randomised prospective cohort study (level 2b) | Days until cessation of whealing | 65.9% of had cessation of whealing by 3 days and a further 15.9% by 7 days in loratidine group, compared with 93.8% by 3 days and a further 3.1% by 7 days in the prednisolone group. Resolution in all patients after >21 days. NNT with prednisolone for resolution of symptoms by 3 days = 4 | Number of children unstated. Different exclusion criteria between groups (potentially pregnant women) |