KETOTIFEN - A REVIEW OF ITS THERAPEUTIC EFFICACY IN DERMATOLOGICAL DISORDERS

In addition to its antihistaminic properties, ketotifen modulates the immune response to allergen challenge in vitro and attenuates dermatol ogical manifestations of the allergic response in vivo. In small rando mised double-blind trials, ketotifen was significantly more effective than placebo in patients with cold urticaria, paediatric mastocytosis (urticaria pigmentosa) or atopic dermatitis, and in prevention of asth ma in infants and children with atopic dermatitis. Additional comparat ive studies showed the drug to be as effective as cetirizine, loratadi ne, astemizole and emedastine as treatment for chronic urticaria, at l east as effective as clemastine as treatment for chronic urticaria and atopic dermatitis but inferior to hydroxyzine as treatment for paedia tric mastocytosis. Ketotifen has shown promise as a treatment for neur ofibromatosis, where previously no pharmacological treatment option wa s available. The most common adverse event in patients treated with ke totifen is sedation; however, the prevalence of this adverse event app ears to subside during continued administration (approximate to 14% in cidence at 3 months reducing to approximate to 2% at endpoint in a 12- month postmarketing study). Other adverse events include dizziness, dr y mouth, nausea, headache and weight gain (incidence approximate to 1 to 2%) Thus ketotifen is a potential therapy for cutaneous mastocytosi s and neurofibromatosis, and has been shown to be an effective treatme nt for urticaria and, particularly, atopic dermatitis. The potential f or the drug to prevent the development of asthma in infants and childr en with the latter provides further rationale for its use.