Treatment of chronic spontaneous urticaria with an inadequate response to H1-antihistamine.

摘要: The second-generation H1-antihistamines (sgAH) are the first-line symptomatic treatment of patients with chronic spontaneous urticaria (CSU). Up to 50% will not respond licensed doses sgAH. According guidelines, dose sgAH may be increased up 4 times conventional dose. However, even at higher doses, there is a subgroup refractory antihistamine treatment. purpose this article was review different options antihistamine-refractory CSU patients. This revision examines available literature for therapies used in urticaria, including omalizumab, ciclosporin A, oral glucocorticoids, leukotriene receptor antagonists, H2 antihistamines, doxepin, dapsone, hydroxychloroquine, phototherapy, methotrexate, mycophenolate mofetil, azathioprine, autohemotherapy, intravenous immunoglobulins and rituximab, between others. After exhaustive medical only few high-quality studies have been identified, mostly omalizumab. Omalizumab an anti-immunoglobulin E monoclonal antibody, approved CSU, that has radically changed management without good response sgAH, allowing reach complete responses high percentage Although actually therapeutic more effective safer than before 2014, place new treatments. A number partial responders slow omalizumab little still non-responders stimulate development drugs also discussed.