title: Insights and advances in chronic urticaria: a Canadian perspective.
abstract: In the past few years there have been significant advances which have changed the face of chronic urticaria. In this review, we aim to update physicians about clinically relevant advances in the classification, diagnosis and management of chronic urticaria that have occurred in recent years. These include clarification of the terminology used to describe and classify urticaria. We also detail the development and validation of instruments to assess urticaria and understand the impairment on quality-of-life and the morbidity caused by this disease. Additionally, the approach to management of chronic urticaria now focuses on evidence-based use of non-impairing, non-sedating H1-antihistamines given initially in standard doses and if this is not effective, in up to 4-fold doses. For urticaria refractory to H1-antihistamines, omalizumab treatment has emerged as an effective, safe option.
authors.affiliation: University of Toronto, Medicine, Toronto, ON Canada.
authors.forename: Gordon
authors.initials: G
authors.lastname: Sussman
authors.affiliation: Université Laval, Medicine, Quebec, QC Canada.
authors.forename: Jacques
authors.initials: J
authors.lastname: Hébert
authors.affiliation: Memorial University, Medicine, Quebec, QC Canada.
authors.forename: Wayne
authors.initials: W
authors.lastname: Gulliver
authors.affiliation: University of Toronto, Medicine, Toronto, ON Canada.
authors.forename: Charles
authors.initials: C
authors.lastname: Lynde
authors.affiliation: McMaster University Medicine, Hamilton, ON Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Waserman
authors.affiliation: University of British Columbia, Medicine, Kelowna, BC Canada.
authors.forename: Amin
authors.initials: A
authors.lastname: Kanani
authors.affiliation: McGill University, Medicine, Montreal, QC Canada.
authors.forename: Moshe
authors.initials: M
authors.lastname: Ben-Shoshan
authors.affiliation: University of Toronto, Medicine, Toronto, ON Canada.
authors.forename: Spencer
authors.initials: S
authors.lastname: Horemans
authors.affiliation: University of Toronto, Medicine, Toronto, ON Canada.
authors.forename: Carly
authors.initials: C
authors.lastname: Barron
authors.affiliation: University of Toronto, Medicine, Toronto, ON Canada.
authors.forename: Stephen
authors.initials: S
authors.lastname: Betschel
authors.affiliation: University of Ottawa, Medicine, Ottawa, ON Canada.
authors.forename: William H
authors.initials: WH
authors.lastname: Yang
authors.affiliation: University of British Columbia, Medicine, Kelowna, BC Canada.
authors.forename: Jan
authors.initials: J
authors.lastname: Dutz
authors.affiliation: University of Toronto, Medicine, Toronto, ON Canada.
authors.forename: Neil
authors.initials: N
authors.lastname: Shear
authors.affiliation: Dalhousie University, Medicine, Halifax, NS Canada.
authors.forename: Gina
authors.initials: G
authors.lastname: Lacuesta
authors.affiliation: University of Toronto, Medicine, Toronto, ON Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Vadas
authors.affiliation: University of Ottawa, Medicine, Ottawa, ON Canada.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Kobayashi
authors.affiliation: McMaster University Medicine, Hamilton, ON Canada.
authors.forename: Hermenio
authors.initials: H
authors.lastname: Lima
authors.affiliation: University of Manitoba, Medicine, Winnipeg, MB Canada.
authors.forename: F Estelle R
authors.initials: FE
authors.lastname: Simons
keywords: Antihistamines; Chronic urticaria; Classification; Diagnosis; Immunology; Management; Omalizumab; Up-dosing