Levocetirizine for the treatment of itch in psoriasis patients: An open-label pilot study in a real-world setting
Abstract
Itch is the most bothersome symptom in psoriasis, often leading to impaired quality of life. Treatment of psoriasis‐induced itch is frequently unsatisfactory as the various therapies employed have a delayed onset of effect. Histamine‐1 receptor (H1) antihistamines are not recommended in treatment guidelines as histamine is not considered a key mediator in psoriasis. However, patients using H1 antihistamines frequently report benefits in questionnaire‐based studies. To address these contradictions, we examined the short‐term effects of levocetirizine, a nonsedating H1 antihistamine, on psoriasis‐related itch and itch‐related quality of life. In this pilot study, patients with psoriasis‐related itch received levocetirizine 5–10 mg daily as a concomitant treatment for 5 days. Change of itch intensity as measured by hourly itch ratings and the change of itch‐related quality of life were measured at different time points. A total of 29 of 30 patients (96%) reported a decline in itch within 5 days. Mean itch reduction was 23% after Day 1 (p = .005), 40% after Day 3 (p < .001), and 41% after Day 5 (p < .001). Furthermore, itch‐related quality of life also significantly improved after 5 days (p < .001). Only 2 of 30 patients (6.7%) reported mild sleepiness. Levocetirizine 5–10 mg daily as an add‐on therapy seems to be an effective treatment to improve itch and itch‐related quality of life within only a few days.
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