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Chronic Spontaneous Urticaria: An Update on the Evaluation and Management
Shyam R Joshi1, Karen M Anstey1, David A Khan2
1Department of Medicine, Section of Allergy and Immunology, Oregon Health and Science University, 3181 Southwest Sam Jackson Park Road, PPV320, Portland, OR 97239, USA.
Immunology and Allergy Clinics of North America
|June 27, 2024
Summary
Chronic spontaneous urticaria (CSU) management guidelines are shifting towards less lab testing. Current treatments include antihistamines and omalizumab, with other options for difficult cases.
Area of Science:
- Allergy and Immunology
- Dermatology
Background:
- Chronic spontaneous urticaria (CSU) impacts 0.5-1% of the population.
- Management has evolved, reducing low-yield laboratory testing.
- Allergy and immunology specialists often manage CSU.
Purpose of the Study:
- To review current management strategies for CSU.
- To discuss the evolving role of laboratory testing and biomarkers.
- To outline therapeutic options for CSU, including refractory cases.
Main Methods:
- Review of current clinical guidelines and literature.
- Analysis of the utility of laboratory testing and biomarkers.
- Evaluation of therapeutic options for CSU.
Main Results:
- Emphasis on decreasing extensive, cost-ineffective laboratory screening.
- Total immunoglobulin E (IgE) may aid in endotype determination and predicting omalizumab response.
- Antihistamines and omalizumab are primary treatments; immunosuppressants and anti-inflammatories are options for refractory CSU.
Conclusions:
- CSU management is moving away from extensive lab work.
- Biomarkers like total IgE show potential utility.
- Current and emerging therapies offer options for CSU patients.
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