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New research revealed at the recent Annual Meeting of the American College of Emergency Physicians shows that intravenous cetirizine is noninferior to IV diphenhydramine in the treatment of acute urticaria, with a better safety profile. The researchers randomized 262 adult patients with acute urticaria who presented to 1 of 19 EDs or urgent care centers from March 2017 to April 2018 to receive either 50 mg IV diphenhydramine or 10 mg IV cetirizine. Primary endpoint was the change in pruritus score from baseline to 2 hours after treatment. The pruritus score fell 1.61 in the cetirizine group and 1.50 in the diphenhydramine. The difference was not statistically significant, but demonstrated noninferiority. Further, adverse events were lower in the cetirizine group (4%) than the diphenhydramine group (13%; P = .0083). JUCM recently published a caser report regarding an 11-year-old girl who was ultimately diagnosed with cold urticaria. Read it (and take the associated CME assessment) in our archive.

New Data Affirm Effective Treatment for Acute Urticaria