#21
REVIEW
Allen P Kaplan
The treatment of chronic spontaneous urticaria begins with antihistamines; however, the dose required typically exceeds that recommended for allergic rhinitis. Second-generation, relatively non-sedating H₁-receptor blockers are typically employed up to 4 times a day. First-generation antihistamines, such as hydroxyzine or diphenhydramine (Atarax or Benadryl), were employed similarly in the past. Should high-dose antihistamines fail to control symptoms (at least 50%), omalizumab at 300 mg/month is the next step...
November 2017: Allergy, Asthma & Immunology Research
#22
REVIEW
Shyam Joshi, David A Khan
Chronic urticaria (CU) is the occurrence of urticaria with or without angioedema for at least 6 weeks. Management has traditionally involved antihistamines as first-line therapy with various alternative therapies for refractory cases. Largely based on the success of biologics for various diseases, this class of drugs has come to the forefront of medical research. The first and only Food and Drug Administration-approved biologic for the management of CU is omalizumab (humanized anti-IgE mAb). In the past decade, a substantial amount of research has been centered on the mechanism of action, efficacy, dosing, and safety of omalizumab...
November 2017: Journal of Allergy and Clinical Immunology in Practice
#23
REVIEW
Susanne Radonjic-Hoesli, Kathrin Scherer Hofmeier, Sara Micaletto, Peter Schmid-Grendelmeier, Andreas Bircher, Dagmar Simon
Urticaria is a common, mast cell-driven disease presenting with wheals or angioedema or both. In the last years, urticaria has increasingly attracted notice to clinicians and researchers, last but not least inspired by the approval of omalizumab, an anti-IgE antibody, for urticaria treatment. There is wide consensus on the clinical classification based on duration and elicitation. However, the pathogenesis is incompletely understood. This review summarizes current guidelines for the management and novel insights in the pathogenesis of urticaria with special focus on their impact on clinical praxis...
February 2018: Clinical Reviews in Allergy & Immunology
#24
JOURNAL ARTICLE
M Pinto Gouveia, A Gameiro, A Pinho, M Gonçalo
BACKGROUND: Clinical trials have shown the efficacy of omalizumabs efficacy in refractory chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU), but real-life management strategies are lacking. AIM: To assess the long-term efficacy and safety of omalizumab, and to identify predictive factors and optimum dosage regimens. METHODS: This was a prospective study of 13 patients (11 women, 2 men) with severe CSU [weekly urticaria activity score (UAS7) > 28] resistant to anti-H1 antihistamines...
October 2017: Clinical and Experimental Dermatology
#25
REVIEW
Tetsuya Honda, Takashi Nomura, Kenji Kabashima
This review highlights recent key advances in the pathology and therapies of inflammatory skin diseases, focusing on atopic dermatitis (AD) and chronic spontaneous urticaria (CSU). Regarding AD, transcriptomic analysis with human samples revealed different immune profiles between childhood and adult AD. Phase III clinical trials of dupilumab, an anti-IL-4 receptor α antibody, in the treatment of AD have successfully finished, and dupilumab will appear in clinical practice as the first biologic for AD in 2017...
August 2017: Journal of Allergy and Clinical Immunology
#26
JOURNAL ARTICLE
Shigeruko Iijima, Kazumi Kojo, Noriko Takayama, Makiko Hiragun, Takanobu Kan, Michihiro Hide
Cholinergic urticaria occasionally occurs in combination with anaphylactic symptoms. However, this has not been widely reported. Herein, we report the case of a 14-year-old Japanese male who was diagnosed with cholinergic urticaria accompanied by anaphylaxis. The patient, who was suffering from atopic dermatitis and bronchial asthma, had developed wheals after exercising or bathing, which would have increased his core body temperature, since summer 2014. He experienced two episodes of severe systemic symptoms and wheal development when he took a bath after eating in December 2014 and the following January...
November 2017: Journal of Dermatology
#27
REVIEW
Paul Schaefer
Urticaria commonly presents with intensely pruritic wheals, sometimes with edema of the subcutaneous or interstitial tissue. It has a lifetime prevalence of about 20%. Although often self-limited and benign, it can cause significant discomfort, continue for months to years, and uncommonly represent a serious systemic disease or life-threatening allergic reaction. Urticaria is caused by immunoglobulin E- and non-immunoglobulin E-mediated release of histamine and other inflammatory mediators from mast cells and basophils...
June 1, 2017: American Family Physician
#28
RANDOMIZED CONTROLLED TRIAL
Caroline Barniol, Emilie Dehours, Jean Mallet, Charles-Henri Houze-Cerfon, Dominique Lauque, Sandrine Charpentier
STUDY OBJECTIVE: We evaluate the efficacy of a 4-day course of prednisone added to antihistamine for the management of acute urticaria in an emergency department (ED). METHODS: In this double-blind randomized clinical trial, patients were eligible for inclusion if aged 18 years or older and with acute urticaria of no more than 24 hours' duration. Patients with anaphylaxis or who had received antihistamines or glucocorticoids during the previous 5 days were not included...
January 2018: Annals of Emergency Medicine
#29
REVIEW
Mario Sánchez-Borges, Luis González-Aveledo, Fernan Caballero-Fonseca, Arnaldo Capriles-Hulett
PURPOSE OF REVIEW: This review aims to update the information available on the prevalence, clinical picture, diagnostic methods, and treatment of urticarias induced by external physical stimuli. RECENT FINDINGS: Physical urticarias are present in up to 5% of the general population, and in 10 to 50% of patients with chronic urticaria. Recent investigations have provided evidence that the presence of physical urticaria alone or when comorbid with chronic spontaneous urticaria is associated with a worse prognosis and duration...
August 2017: Current Allergy and Asthma Reports
#30
JOURNAL ARTICLE
Tatevik Ohanyan, Nicole Schoepke, Bediha Bolukbasi, Martin Metz, Tomasz Hawro, Torsten Zuberbier, Adriane Peveling-Oberhag, Petra Staubach, Marcus Maurer, Karsten Weller
No abstract text is available yet for this article.
December 2017: Journal of Allergy and Clinical Immunology
#31
JOURNAL ARTICLE
Murat Türk, İnsu Yılmaz, Sakine Nazik Bahçecioğlu
BACKGROUND: Previous data have shown the high efficacy of omalizumab in chronic spontaneous urticaria (CSU). However, factors that may be effective on the response to therapy, relapse rates after drug discontinuation, and efficacy of retreatment remain unclear. This study aimed to determine the efficacy of omalizumab in CSU refractory to conventional therapy, to identify possible factors affecting treatment response and relapse, and also to evaluate the efficacy of retreatment on relapsed disease...
January 2018: Allergology International: Official Journal of the Japanese Society of Allergology
#32
REVIEW
Gino A Vena, Marcus Maurer, Nicoletta Cassano, Torsten Zuberbier
PURPOSE OF REVIEW: The international EAACI/GALEN/EDF/WAO guideline suggests a stepwise approach for the therapeutic management of chronic spontaneous urticaria (CSU), outlined in an algorithm. The aim of this article is to summarize and review the evidence available on alternative treatment options for CSU outside of this algorithm. RECENT FINDINGS: Although CSU is a common disease, there are a limited number of high-quality studies, and only antihistamines and omalizumab are licensed for its treatment...
August 2017: Current Opinion in Allergy and Clinical Immunology
#33
REVIEW
Fang Wang, Yu-Kun Zhao, Ze-Yu Luo, Qian Gao, Wei Wu, Rashmi Sarkar, Di-Qing Luo
Aquagenic cutaneous disorders, which include aquagenic urticaria, aquagenic pruritus, and aquagenic acrokeratoderma, are a group of rare diseases characterized by skin lesions or discomfort induced by brief contact with water. Aquagenic urticaria is characterized by pruritic wheals that occur at the sites of water contact, either immediately or within minutes, and disappear within 30-60 min after water removal. Aquagenic pruritus presents with severe pruritus or a stinging, tingling, or burning sensation without any visible skin changes...
June 2017: Journal der Deutschen Dermatologischen Gesellschaft: JDDG
#34
RANDOMIZED CONTROLLED TRIAL
Martin Metz, Petra Staubach, Andrea Bauer, Randolf Brehler, Janine Gericke, Michael Kangas, Joanna Ashton-Chess, Philip Jarvis, Panayiotis Georgiou, Janice Canvin, Rainer Hillenbrand, Veit J Erpenbeck, Marcus Maurer
Background. Treatment with omalizumab, a humanized recombinant monoclonal anti-IgE antibody, results in clinical efficacy in patients with Chronic Spontaneous Urticaria (CSU). The mechanism of action of omalizumab in CSU has not been elucidated in detail. Objectives. To determine the effects of omalizumab on levels of high affinity IgE receptor-positive (FcεRI+ ) and IgE-positive (IgE+ ) dermal cells and blood basophils. Treatment efficacy and safety were also assessed. Study design. In a double-blind study, CSU patients aged 18‑75 years were randomized to receive 300 mg omalizumab (n=20) or placebo (n=10) subcutaneously every 4 weeks for 12 weeks...
2017: Theranostics
#35
REVIEW
K Rutkowski, C E H Grattan
Chronic urticaria (CU) is a disease characterized by pruritic weals, angio-oedema or both occurring for at least 6 weeks. It encompasses spontaneous and inducible urticarias. The national and international guidelines outline the principles of treatment. Omalizumab, an anti-immunoglobulin E monoclonal antibody, has transformed the management of many severe and treatment-refractory patients. However, current UK guidance on its use does not address the needs of those with less severe disease, inducible urticarias, idiopathic histaminergic angio-oedema without weals as a presentation of CU and omalizumab non-responders...
June 2017: Clinical and Experimental Allergy
#36
REVIEW
P Kolkhir, M Metz, S Altrichter, M Maurer
Patients with chronic spontaneous urticaria (CSU) are widely held to often have other autoimmune disorders, including autoimmune thyroid disease. Here, we systematically evaluated the literature on the prevalence of thyroid autoimmunity in CSU and vice versa. There is a strong link between CSU and elevated levels of IgG antithyroid autoantibodies (AAbs), with most of a large number of studies reporting rates of ≥10%. Levels of IgG against thyroid peroxidase (TPO) are more often elevated in CSU than those of other IgG antithyroid AAbs (strong evidence)...
October 2017: Allergy
#37
REVIEW
Stanley Goldstein, Susan Gabriel, Farid Kianifard, Benjamin Ortiz, David P Skoner
BACKGROUND: Adults and adolescents were included in 3 phase 3 omalizumab trials in chronic idiopathic urticaria (CIU): ASTERIA I, ASTERIA II, and GLACIAL. OBJECTIVE: To describe the baseline clinical profile of adolescent patients with CIU enrolled in the omalizumab trials to add to the limited literature available on CIU in this population. METHODS: Data for patient demographics, baseline clinical disease characteristics, medical history, and previous CIU medication information (not efficacy assessments) from phase 3 omalizumab trials were pooled and descriptive statistical analyses performed for adolescent (12 to <18 years old) and adult (≥18 years old) subgroups...
April 2017: Annals of Allergy, Asthma & Immunology
#38
JOURNAL ARTICLE
Emek Kocatürk, Pelin Kuteyla Can, Pırıl Etikan Akbas, Mehmet Copur, Ece Nur Degirmentepe, Kübra Kızıltac, Ralfi Singer
BACKGROUND: The recommended treatment approach in chronic inducible urticarias (CIndU) is the same as that for chronic spontaneous urticaria (CSU). But there is a lack of controlled trials assessing efficacy of available treatment options. OBJECTIVE: We aimed to evaluate the efficacy of treatment algorithm recommended by the guidelines and comparison of treatment responses in CIndU vs CSU. METHODS: This prospective parallel group controlled study included 70 CIndU and 66 CSU patients...
July 2017: Journal of Dermatological Science
#39
JOURNAL ARTICLE
Seung Jin Lee, Eun Kyo Ha, Hye Mi Jee, Kyung Suk Lee, Seung Won Lee, Mi Ae Kim, Dong Hyun Kim, Young Ho Jung, Youn Ho Sheen, Myong Soon Sung, Man Yong Han
PURPOSE: Limited data is available on the prevalence and risk factors of acute and chronic urticaria in children. Our purpose was to determine the prevalence and identify the risk factors of acute and chronic urticaria in Korean children. METHODS: This population-based study examined 4,076 children (age 4 to 13 years) who were enrolled in the 2015 prospective Seongnam Atopy Project (SAP 2015) in Korea. The parents completed an urticaria questionnaire that included questions regarding the duration, severity, and triggering factors of urticaria...
May 2017: Allergy, Asthma & Immunology Research
#40
REVIEW
M Sánchez-Borges, F Caballero-Fonseca, A Capriles-Hulett, L González-Aveledo, M Maurer
Biomarkers useful for the evaluation and management of patients with chronic spontaneous urticaria (CSU) are not currently available. A review of various clinical and laboratory markers that have been studied to assess their value for determining the severity or predicting the evolution of disease in adult patients with CSU was carried out. A search of the medical literature on PubMed and MEDLINE including the terms urticaria, chronic urticaria, chronic idiopathic urticaria, CSU, severity, prognosis and treatment was performed...
June 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
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