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Steroids for Hives

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Note: conundrums are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also regarding your thought processes and the evidence behind your decisions. We can learn from each other!

Do you use short steroid bursts in the treatment of ACUTE urticaria?

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pemsou5_wp • February 22, 2019

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  1. Kelly March 4, 2019 - 9:13 pm Reply

    There are surprisingly few trials of short steroid bursts in the treatment of acute urticaria. Two early studies (Pollack CV et al Ann Emerg Med 1995;26(5):547 and Zuberbier T et al Acta Derm Venereol 1996;76(4):295 support quicker resolution of hives and itching with a 3-4 day burst of prednisone or prednisolone. However, a more recent randomized double-blind clinical trial (Barniol C et al Ann Emerg Med 2018;71(1):125) did not show any statistically significant difference, although the 95% confidence interval was consistent with a possibly clinically significantly higher proportion of patients with an itch score of zero at 2 day follow-up in those receiving prednisone for 4 days. These were not studies of children.

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