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Treatment of chronic spontaneous urticaria with an inadequate response to H1-antihistamines: an expert opinion

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dc.contributor.author Vestergaard, Christian
dc.contributor.author Toubi, Elias
dc.contributor.author Maurer, Marcus
dc.contributor.author Triggiani, Massimo
dc.contributor.author Ballmer-Weber, Barbara K.
dc.contributor.author Marsland, Alexander
dc.contributor.author Ferrer, Marta
dc.contributor.author Knulst, André
dc.contributor.author Giménez Arnau, Anna Maria
dc.date.accessioned 2018-03-15T12:08:20Z
dc.date.available 2018-03-15T12:08:20Z
dc.date.issued 2017
dc.identifier.citation Vestergaard C, Toubi E, Maurer M, Triggiani M, Ballmer-Weber B, Marsland A. Treatment of chronic spontaneous urticaria with an inadequate response to H1-antihistamines: an expert opinion. Eur J Dermatol. 2017 Feb 1;27(1):10-19. DOI: 10.1684/ejd.2016.2905
dc.identifier.issn 1167-1122
dc.identifier.uri http://hdl.handle.net/10230/34181
dc.description.abstract Chronic spontaneous urticaria (CSU) is characterized by the sudden, continuous or intermittent appearance of pruritic wheals (hives), angioedema, or both for six weeks or more, with no known specific trigger. The international EAACI/GA2LEN/EDF/WAO urticaria guideline advises standard-dose, second-generation H1-antihistamines as first-line therapy. However, H1-antihistamine treatment leads to absence of symptoms in fewer than 50% of patients. Updosing of second-generation H1-antihistamines (up to fourfold) as recommended by the EAACI/GA2LEN/EDF/WAO urticaria guideline as second-line therapy, can improve response, but many patients remain symptomatic. Definitions of response are often subjective and a consensus is needed regarding appropriate treatment targets. There is also an unmet need for biomarkers to assess CSU severity and activity and to predict treatment response. The EAACI/GA2LEN/EDF/WAO urticaria guideline recommends add-on omalizumab, ciclosporin A (CsA), or montelukast third-line treatment in patients with an inadequate response to high-dose H1-antihistamines. Omalizumab is currently the only licensed systemic biologic for use in CSU. Both omalizumab and CsA are effective third-line CSU treatments; montelukast appears to have lower efficacy in this setting. Omalizumab carries a label warning for anaphylaxis, although no cases of anaphylaxis were reported in the phase III trials of omalizumab in CSU and it is generally well tolerated in patients with CSU. Omalizumab arguably has a better safety profile than CsA.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher John Libbey Eurotext
dc.relation.ispartof European Journal of Dermatology. 2017 Feb 1;27(1):10-9
dc.rights © John Libbey Eurotext http://dx.doi.org/10.1684/ejd.2016.2905
dc.title Treatment of chronic spontaneous urticaria with an inadequate response to H1-antihistamines: an expert opinion
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1684/ejd.2016.2905
dc.subject.keyword H1-antihistamines
dc.subject.keyword Chronic spontaneous urticarial
dc.subject.keyword Omalizumab
dc.subject.keyword Response
dc.subject.keyword Treatment
dc.subject.keyword Urticària
dc.subject.keyword Antihistamínics
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/acceptedVersion

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