Alternative treatments for chronic spontaneous urticaria beyond the guideline algorithm

Area of Science:

• Dermatology
• Immunology
• Allergy

Background:

• Chronic spontaneous urticaria (CSU) is a common condition.
• Current guidelines recommend a stepwise treatment approach.
• Limited high-quality studies exist for CSU therapies.

Purpose of the Study:

• To review evidence on alternative treatments for CSU outside established guidelines.
• To summarize therapeutic options for refractory CSU patients.

Main Methods:

• Literature review of recent publications on CSU alternative therapies.
• Analysis of studies on treatments like adalimumab, rituximab, vitamin D, probiotics, and phototherapy.

Main Results:

• Only antihistamines and omalizumab are licensed for CSU treatment.
• Most alternative therapies for CSU have methodological limitations and high risk of bias.
• Evidence for alternative CSU treatments is generally low or very low.

Conclusions:

• Numerous alternative treatments have been explored for refractory CSU.
• Further research is essential to establish efficacy and safety of alternative CSU therapies.
• Improved management strategies are needed for CSU patients unresponsive to standard treatments.