Adjunctive treatment of chronic idiopathic urticaria and angioedema with sulfasalazine

Urticaria is a common condition that affects as many as 25% of people at some time in their lives. Chronic recurrent urticaria and angioedema can be frustrating and often refractory to conventional treatment. The purpose of this study was to evaluate the efficacy of Sulfasalazine in the treatment of unremitting recurrent urticaria and angioedema.

We performed a retrospective chart review of 20 patients with chronic idiopathic urticaria/angioedema (CIU) treated with Sulfasalazine as adjunctive therapy at the Winnipeg Health Science Centre from 2005-2009. We recorded demographic data, response to Sulfasalazine, presence of the IgE receptor antibody, and side effects.

20 patients were treated with Sulfasalazine as adjunctive therapy and 1 patient was lost to follow up. The patient’s ages ranged between 27-75 years with a mean of 48 years and 10 (50%) were female. IgE receptor antibody status was determined in 12 patients and 6 patients were positive. Out of the 19 patients who are still being followed, 10(52.6%) failed to respond to the Sulfasalazine, and 9(47.4%) responded to Sulfasalazine with 2 partial responders and 7 complete responders. Side effects noted included: increased liver function tests, leucopenia, dyspepsia, flatulence nausea, pyrosis and a rash.

Sulfasalazine may be a useful adjunctive treatment for patients with CIU. Larger blinded, placebo controlled trials are required to confirm its efficacy.