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Expert Opinion on Pharmacotherapy 2020-Sep

Current and Emerging Pharmacotherapy for Chronic Spontaneous Urticaria: A Focus on Non-biological Therapeutics

Rakstu tulkošanu var veikt tikai reģistrēti lietotāji
Ielogoties Reģistrēties
Saite tiek saglabāta starpliktuvē
Kam Hon
Joyce Li
Alexander Leung
Vivian Lee

Atslēgvārdi

Abstrakts

Introduction: Chronic spontaneous urticaria (CSU) refers to urticaria (wheals) or angioedema, which occur for a period of six weeks or longer without an apparent cause. The condition may impair the patient's quality of life.

Areas covered: Treatment for CSU is mainly symptomatic. Both AAAAI/ACAAI practice parameters and EAACI/GA2LEN/EDF/WAO guidelines suggest CSU management in a stepwise manner. First-line therapy is with second-generation H1-antihistamines. Treatment should be stepped up along the algorithm if symptoms are not adequately controlled. Increasing dosage of second-generation H1-antihistamines, with addition of first-generation H1-atihistamines, H2 antagonist, omalizumab, ciclosporin A, or short-term corticosteroid may be necessary. New medications are being developed to treat refractory CSU. They include spleen tyrosine kinase inhibitor, Bruton tyrosine kinase inhibitor, prostaglandin D2 receptor inhibitor, H4-antihistamine and other agents. The authors discuss these treatments and provide expert perspectiveson the management of CSU.

Expert opinion: Second-generation H1-antihistamines remain the first-line therapeutic options for the management of CSU. For patients not responding to higher-dose H1-antihistamines, international guidelines recommend the addition of omalizumab. Efficacy and safety data for newer agents are still pending. Large-scale, well-designed, randomized, double-blind, placebo-controlled trials will further provide evidence on the safety profile and efficacy of these agents in patients with CSU.

Keywords: Antihistamines; angioedema; hives; idiopathic; omalizumab; pruritus; wheals.

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