Double-Blind Placebo-Controlled Trial of Dapsone in Antihistamine Refractory Chronic Idiopathic Urticaria

Morgan, Matt; Cooke, Andrew; Rogers, Laura Q.; Adams‐Huet, Beverley; Khan, David A.

doi:10.1016/j.jaip.2014.06.004

Cited by 52 publications

(38 citation statements)

References 39 publications

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“…One recent double-blind, placebo study of dapsone suggests efficacy [106] but the placebo group has very low response rate so the efficacy may be inflated. Sulfasalazine is better studied [107] than most of the other agents listed but without clear control groups.…”

Section: Resultsmentioning

confidence: 99%

Management of urticaria: not too complicated, not too simple

Ferrer

Bartra

Giménez‐Arnau

et al. 2015

Clin Experimental Allergy

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In spite of being an old disease and apparently easy to diagnose, chronic spontaneous urticaria (CSU) is still perceived as an uncontrollable and difficult to manage disease. The perception of the patient is that his/her condition is not well understood and that is suffering from a disorder with hidden causes that doctors are not able to tackle. Sometimes patients go through a number of clinicians until they found some CSU expert who is familiar with the disease. It is surprising that myths and believes with no scientific support still persist. Guidelines are not widely implemented, and recent tools to assess severity are infrequently used. European and American recent guidelines do not agree in several key points related to diagnosis and treatment, which further contributes to confusion. With the aim to clarify some aspects of the CSU picture, a group of allergists and dermatologists from the Spanish Dermatology and Allergy societies developed a Frequent Asked Questions leaflet that could facilitate physicians work in daily practice and contribute to a better knowledge of common clinical scenarios related to patients with CSU.

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Section: Resultsmentioning

confidence: 99%

Management of urticaria: not too complicated, not too simple

Ferrer

Bartra

Giménez‐Arnau

et al. 2015

Clin Experimental Allergy

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“…Case reports [52] and, recently, a double-blind placebo-controlled study [53] support the effectiveness of dapsone, an antiinflammatory drug, in patients with recalcitrant CSU.…”

Section: Other Drugsmentioning

confidence: 93%

Current challenges and controversies in the management of chronic spontaneous urticaria

Asero¹,

Pinter²,

Marra³

et al. 2015

Expert Review of Clinical Immunology

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Chronic spontaneous urticaria (CSU) is characterized by the recurrence of itchy wheals for at least 6 weeks, affects up to 1% of the general population and may severely impair quality of life. H1-antihistamines are the cornerstones of treatment, but in about 10% of cases they fail to control the disease even at higher than licensed doses. In these patients, short courses of oral steroids may induce a remission in about 50% of cases. Omalizumab, a monoclonal anti-IgE, is effective in antihistamine-unresponsive patients although optimal treatment duration needs to be defined. Immunosuppressive treatment with cyclosporine is also effective in the majority of antihistamine-resistant chronic spontaneous urticaria (CSU) patients, but its use is limited by potential side effects. In refractory patients, other approaches include intravenous immunoglobulin, rituximab, dapsone and anticoagulants. The present review looks with particular interest at the prevalence of treatment failures with the main third-level treatments (corticosteroids, omalizumab and cyclosporine) and discusses them in light of the possible different pathogenic mechanisms underlying chronic spontaneous urticaria.

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“…The current international urticaria guideline was unable to provide a recommendation for or against the use of dapsone and its benefits remain unclear. However, results from a double‐blind, placebo‐controlled trial of dapsone have shown promising efficacy for this therapeutic agent in patients with antihistamine refractory chronic urticaria . It is worth noting, however, that this trial used the Visual Analogue Scale rather than the recommended 7‐day Urticaria Activity Score (UAS7) to assess treatment effectiveness.…”

Section: Introductionmentioning

confidence: 99%

Controversies and challenges in the management of chronic urticaria

Staubach

Zuberbier

Vestergaard

et al. 2016

Acad Dermatol Venereol

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This supplement reports proceedings of the second international Global Urticaria Forum, which was held in Berlin, Germany in November 2015. Despite the clear international guideline, there remain a number of controversies and challenges in the management of patients with chronic urticaria (CU). As a result of major advancements in urticaria over the past 4 years, the current EAACI/GA 2 LEN/EDF/WAO urticaria guideline treatment algorithm requires updating. Case studies from patients with chronic spontaneous urticaria (CSU) [also called chronic idiopathic urticaria (CIU)], chronic inducible urticaria (CIndU) or diseases and syndromes related to CU are useful in describing and exploring challenges in disease management. Case studies of specific CSU patient populations such as children with CU or patients with angioedema but no hives also require consideration as potentially challenging groups with unmet needs. The current EAACI/ GA 2 LEN/EDF/WAO urticaria guideline provides a general framework for the management of patients with CU but, as these cases highlight, a personalized approach based on the expert knowledge of the physician may be required.

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Double-Blind Placebo-Controlled Trial of Dapsone in Antihistamine Refractory Chronic Idiopathic Urticaria

Cited by 52 publications

References 39 publications

Management of urticaria: not too complicated, not too simple

Management of urticaria: not too complicated, not too simple

Current challenges and controversies in the management of chronic spontaneous urticaria

Controversies and challenges in the management of chronic urticaria

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