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2016 ; 5
(ä): ä Nephropedia Template TP
gab.com Text
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English Wikipedia
Advances in Understanding and Managing Chronic Urticaria
#MMPMID26949520
Moolani Y
; Lynde C
; Sussman G
F1000Res
2016[]; 5
(ä): ä PMID26949520
show ga
There have been recent advances in the classification and management of chronic
urticaria. The new term chronic spontaneous urticaria (CSU) has replaced chronic
idiopathic urticaria and chronic autoimmune urticaria. In addition, chronic
inducible urticaria (CINDU) has replaced physical urticaria and includes other
forms of inducible urticaria, such as cholinergic and aquagenic urticaria.
Furthermore, novel research has resulted in a new understanding with guidelines
being revised in the past year by both the American Academy of Allergy, Asthma,
and Immunology (AAAAI) and the European Academy of Allergy and Clinical
Immunology (EAACI)/Global Allergy and Asthma European Network (GA
(2)LEN)/European Dermatology Forum (EDF)/World Allergy Organization (WAO). There
are some differences in the recommendations, which will be discussed, but the
core updates are common to both groups. The basic treatment for chronic urticaria
involves second-generation non-sedating non-impairing H 1 antihistamines as
first-line treatment. This is followed by up to a 4-fold increase in the licensed
dose of these H 1 antihistamines. The major therapeutic advance in recent years
has been in third-line treatment with omalizumab, a humanized monoclonal
anti-immunoglobulin E (anti-IgE) antibody that prevents binding of IgE to the
high-affinity IgE receptor. Several multicenter randomized controlled trials have
shown safety and efficacy of omalizumab for CSU. There are also some small
studies showing efficacy of omalizumab in CINDU. While there were previously many
treatment options which were lacking in strong evidence, we are moving into an
era where the treatment algorithm for chronic urticaria is simplified and
contains more evidence-based, effective, and less toxic treatment options.