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Guideline of Chronic Urticaria Beyond
Lauren M Fine1, Jonathan A Bernstein2
1Department of Medicine, University of Miami Miller School of Medicine, Department of Internal Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Miami, FL, USA.
Allergy, Asthma & Immunology Research
|June 24, 2016
Summary
Chronic urticaria significantly impacts quality of life and is often difficult to treat. Omalizumab, an anti-IgE therapy, effectively controls chronic urticaria in many patients unresponsive to standard treatments.
Area of Science:
- Dermatology
- Immunology
- Allergy
Background:
- Chronic urticaria (CU) is a common condition affecting quality of life, with often undetermined etiology.
- Autoimmune factors are suspected in many CU cases, but diagnostic and management strategies remain debated.
- Standard treatments like antihistamines and corticosteroids are insufficient for many patients, necessitating advanced therapies.
Purpose of the Study:
- To review the current understanding and management of chronic urticaria.
- To evaluate the efficacy and safety of omalizumab for chronic urticaria.
- To discuss the limitations and future directions in CU treatment.
Main Methods:
- Review of existing literature on chronic urticaria etiology, diagnosis, and treatment.
- Analysis of studies on the use of immunosuppressants like cyclosporine and mycophenolate mofetil.
- Evaluation of clinical trial data for omalizumab in H1-antagonist-unresponsive chronic urticaria.
Main Results:
- Omalizumab, an IgG anti-IgE monoclonal antibody, is approved for H1-antagonist-unresponsive chronic urticaria.
- Omalizumab effectively controls chronic urticaria in approximately two-thirds of patients.
- Evidence for older immunomodulating drugs like cyclosporine and mycophenolate mofetil remains limited.
Conclusions:
- Omalizumab offers a safe and effective treatment option for refractory chronic urticaria.
- Further research is needed to clarify omalizumab's mechanism of action and optimal treatment duration.
- Defining the pathobiology of chronic urticaria will enable the development of targeted future therapies.
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