title: Update and insights into treatment options for chronic spontaneous urticaria.
abstract: Chronic spontaneous urticaria (CSU) is defined as itchy weals, angio-oedema, or both, arising spontaneously without external physical stimuli. Symptoms of the disease continue to develop for more than 6 weeks. It carries a high socioeconomic burden with considerable health care costs. Second generation H1-antihistamines are the mainstay of urticaria treatment and are the only licensed option. However, many patients are resistant to H1-antihistamine therapy. Omalizumab has proven to be an effective therapeutic option in patients with recalcitrant chronic urticaria. Ciclosporin appears to be more beneficial in patients with functional histamine releasing autoantibodies as a cause of their disease. This review article will highlight the major therapeutic options available today for the management of CSU knowing that good quality evidence for efficacy of many agents is scarce except for H1-antihistamines and omalizumab.
authors: Department of Dermatology, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK.
authors: Nadine
authors: N
authors: Marrouche
authors: Clive
authors: C
authors: Grattan
mesh_terms: D000799:Angioedema / Q000276:immunology / Q000628:therapy*; D000888:Antibodies, Anti-Idiotypic / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D016572:Cyclosporine / Q000627:therapeutic use*; D004351:Drug Resistance; D039563:Histamine H1 Antagonists, Non-Sedating / Q000627:therapeutic use*; D006801:Humans; D007167:Immunotherapy / Q000379:methods* / Q000639:trends; D000069444:Omalizumab; D011537:Pruritus / Q000276:immunology / Q000628:therapy*; D012867:Skin / Q000473:pathology*; D014581:Urticaria / Q000276:immunology / Q000628:therapy*
chemical_list: D000888:Antibodies, Anti-Idiotypic; D061067:Antibodies, Monoclonal, Humanized; D039563:Histamine H1 Antagonists, Non-Sedating; D000069444:Omalizumab; D016572:Cyclosporine