title: The Comparative Safety of Multiple Alternative Agents in Refractory Chronic Urticaria Patients.
abstract: Patients who have failed traditional treatment of chronic urticaria may require trials of alternative medications. Safety profiles, continuous laboratory monitoring, and physician comfort are often barriers to treatment.
  
  
  
  To evaluate the safety of alternative agents used in chronic urticaria.
  
  
  
  A retrospective chart review of electronic medical records from a single-center allergy and immunology clinic in a major academic hospital was conducted. One hundred twenty-six charts of patients with chronic urticaria treated with alternative agents were reviewed.
  
  
  
  Adverse effects were reported in 39 of 73 (53%) patients on dapsone, 19 of 47 (40%) patients on sulfasalazine, 15 of 36 (42%) patients on tacrolimus, 7 of 45 (16%) patients on hydroxychloroquine, 9 of 27 (33%) patients on mycophenolate, 6 of 8 (75%) patients on cyclosporine, and 3 of 24 (4%) patients on omalizumab. Most of these adverse effects were mild, did not require discontinuation of the medication, and resolved after stopping the medication or decreasing the dose.
  
  
  
  The use of alternative agents for the treatment of chronic urticaria angioedema is generally safe when proper laboratory and clinical monitoring is observed.
authors.affiliation: Division of Allergy and Immunology, University of Texas Southwestern Dallas, Dallas, Texas. Electronic address: sharonjd111@gmail.com.
authors.forename: Sharon
authors.initials: S
authors.lastname: Seth
authors.affiliation: Division of Allergy and Immunology, University of Texas Southwestern Dallas, Dallas, Texas.
authors.forename: David A
authors.initials: DA
authors.lastname: Khan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003622:Dapsone / Q000627:therapeutic use*; D057286:Electronic Health Records; D005260:Female; D005493:Folic Acid Antagonists / Q000627:therapeutic use*; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D000069444:Omalizumab / Q000627:therapeutic use*; D012008:Recurrence; D012189:Retrospective Studies; D012460:Sulfasalazine / Q000627:therapeutic use*; D016896:Treatment Outcome; D014581:Urticaria / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D005493:Folic Acid Antagonists; D007166:Immunosuppressive Agents; D000069444:Omalizumab; D012460:Sulfasalazine; D006886:Hydroxychloroquine; D003622:Dapsone
keywords: Alternative agents; Angioedema; Chronic urticaria; Dapsone; Hydroxychloroquine; Mycophenolate; Sulfasalazine; Tacrolimus