Current therapeutic options for adult patients with urticarial vasculitis: A scoping review

Urticarial vasculitis (UV) is a rare form of small vessel vasculitis, and there are limited published data on its management.

This study aims to review the current therapeutic options for UV.

A PubMed search was conducted, selecting articles published from 2000 to January 2024.

Of 305 identified articles, 21 were included. Mild cutaneous UV can be treated with antihistamines and nonsteroidal anti-inflammatory drugs. For intermittent cutaneous UV, short courses of systemic corticosteroids are recommended. Hydroxychloroquine, colchicine, and dapsone show comparable efficacy to corticosteroids and are often used for refractory and hypocomplementemic UV patients. In cases with persistent symptoms, first-line immunosuppressants such as azathioprine, cyclophosphamide, cyclosporine A, methotrexate, and mycophenolate mofetil may be considered. Some studies suggest the effectiveness of omalizumab, rituximab, canakinumab, anakinra, and plasmapheresis.

Only noninterventional observational studies, which were mostly retrospective, were found and included in our scoping review. Furthermore, the study is limited by small sample sizes due to the nature of UV.

UV is a rare condition with insufficient treatment data. This scoping review outlines potential treatment options, highlighting the need for further research.