MedicalResearch.com Interview with:
Nicholas A. Soter, MD
The Ronald O. Perelman Department of Dermatology
New York University School of Medicine
New York, New York
MedicalResearch.com: What is the background for this study?
Response: Nearly 50% of patients with chronic spontaneous urticarial (CSU) (hives) incompletely respond to first-line therapy with H-1 antihistamines.
However, in the current literature, there is limited evidence to guide the treatment of CSU after maximal therapy with antihistamines fails. Two small, randomized, controlled trials suggest that dapsone, which is an antimicrobial therapeutic agent with anti-inflammatory properties, may be a useful second-line therapeutic agent.
MedicalResearch.com: What are the main findings?
Response: In our study of 79 patients with chronic spontaneous urticarial, both idiopathic and autoimmune subtypes, 79% experienced improvement, 37% achieved a complete response, and 13% experienced remission with dapsone therapy. For most patients, improvement occurred within one month, and complete response occurred in about five months.
Dapsone was well-tolerated in our study as the majority of adverse effects were mild.
MedicalResearch.com: What should readers take away from your report?
Response: Dapsone is an effective and safe second-line therapy for patients with chronic spontaneous urticaria, in whom antihistamines and other agents have failed.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Future studies are needed to further elucidate dapsone’s mechanism of action as well as double-blind, controlled studies and comparative studies to other second and third line therapeutic agents are needed. However, many of the patients in our study had previously failed other therapeutic agents, which include omalizumab, and only achieved control of chronic spontaneous urticarial with dapsone.
MedicalResearch.com: Is there anything else you would like to add?
Response: One hopes that this study helps to augment the medical community’s understand of the use of dapsone the treatment of CSU, which is a condition that often is challenging to manage. Also, one hopes that these findings will support dapsone’s place in the therapeutic armamentarium of chronic spontaneous urticarial and will help guide the treatment of CSU in the future. There are no disclosures.
Liang SE, Hoffmann R, Peterson E, Soter NA. Use of Dapsone in the Treatment of Chronic Idiopathic and Autoimmune Urticaria. JAMA Dermatol. Published online November 21, 2018. doi:10.1001/jamadermatol.2018.3715
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