Management and treatment of chronic urticaria (CU)

Abstract

Developments increasing our understanding of chronic urticaria have resulted in the simplification and improvement of available treatments. Currently, many treatments target mast cell mediators, but we can now disrupt mast cell activation with the anti-IgE antibody omalizumab, which has markedly advanced the treatment landscape for patients with difficultto-treat urticaria. Current guidelines provide a framework for the management and treatment of patients with CU but, as each patient is different, knowledge and experience of specialist dermatologists and allergists are key to effective pharmacotherapy. This article reviews the different therapeutic options for patients with chronic spontaneous urticaria (also called chronic idiopathic urticaria) or chronic inducible urticaria and discusses management of special populations or special circumstances related to CU.

Effectiveness of Autologous Whole-Blood Injections in Patients with Refractory Chronic Spontaneous Urticaria

“…Recent meta-analysis has provided high-level evidence for the efficacy and safety of omalizumab in patients with refractory CSU [2]. Nevertheless, several issues with respect to anti-IgE treatment are still of concern, such as the lack of evidence for CSU immunomodulation or symptomatology recurrence following discontinuation [3,4]. Although leukotriene antagonists are proposed in the European Academy of Allergy and Clinical Immunology/Global Allergy and Asthma European Network (EAACI/GA 2 LEN) guidelines in cases of refractory chronic urticaria, well-designed randomized controlled trials about their role in CSU treatment are lacking [5].…”

Features of the complement system in children with chronic urticaria

“…Пациентам с хронической крапивницей с повы-шением уровня С1inh на фоне снижения концентра-ции С4 (n=10) проводилось повторное исследование уровня компонентов комплемента после стандартной терапии первой или второй линий (антигистаминные препараты или антигистаминные+антилейкотриенов ые) [17]. У 7 из 10 больных через 1-1,5 мес показате-ли приобретали нормальные значения.…”

Urticária Crónica - Do Diagnóstico ao Tratamento

“…65 Os corticoides sisté-micos podem ser usados na mulher grávida, à semelhança do tratamento de doença reumatológica ou asma, mas na menor dose possível e por pequenos períodos. 66 Não parece haver risco acrescido com o montelucaste na mulher grávi-da mas a escassez de estudos clínicos não permite atestar um grau de evidência clínico satisfatório. 67 A ciclosporina deve ser considerada com extrema precaução devido aos seus potenciais efeitos embriotóxicos e teratogénicos.…”