Comparison of Remission with Autologous Serum Therapy versus Fixed-Dose Levocetirizine in Chronic Urticaria: A Quasi-Experimental Study

Remission with Autologous Serum Therapy versus Fixed-Dose Levocetirizine in Chronic Urticaria

Abstract

Chronic urticaria is a relapsing disorder characterized by recurrent wheals and pruritus for more than 6 weeks. Although second-generation H1-antihistamines remain first-line therapy, some patients show incomplete control, prompting interest in autologous serum therapy (AST). Objectives: To compare remission rates with AST versus fixed-dose levocetirizine in adults with chronic urticaria. Methods: This quasi-experimental study was conducted in the Department of Dermatology, Sheikh Zayed Hospital, Rahim Yar Khan, from March 21, 2024, to September 20, 2024. Eighty-eight adults with clinically diagnosed chronic urticaria were enrolled by non-probability consecutive sampling and allocated non-randomly to AST (n=44) or levocetirizine 5 mg daily (n=44). AST was prepared from autologous venous blood and administered as 2 mL intramuscular injections once weekly during the active treatment phase. Outcome assessment was not blinded. The primary endpoint was the complete absence of wheals and itching during the final 7 consecutive days of treatment. Chi-square testing was used for efficacy comparisons, and relative risk (RR) with 95% confidence interval (CI) was calculated. Results: Complete remission was observed in 34/44 patients (77.3%) receiving AST and 21/44 (47.7%) receiving levocetirizine (p=0.004; RR 1.62, 95% CI 1.14–2.29). Exploratory subgroup analyses showed higher remission with AST among patients aged 31–45 years (p=0.027) and among those with disease duration <6 months (p=0.006). No major adverse events were documented in the available study records; however, minor adverse events were not systematically assessed or reported. Conclusions: This non-randomized, unblinded study, AST showed higher short-term remission than fixed-dose levocetirizine, but findings remain hypothesis-generating and require confirmation through randomized controlled trials.