Chronic urticaria: a comparison of management guidelines.

Abstract

INTRODUCTION:

Chronic urticaria is characterized by recurring episodes of spontaneous transient dermal wheals and pruritus, with or without angioedema, which can persist for ≥ 6 weeks. Chronic urticaria impairs quality of life, emphasizing the need for effective treatments. Professional societies and clinical experts have issued evidence-based recommendations for the management of chronic urticaria, including recommending the use of second-generation antihistamines as a first-line therapy.

AREAS COVERED:

A Medline search was conducted from 2000 to 2011 using the following terms, alone or in combination: 'chronic urticaria', 'management guidelines', 'consensus guidelines' and 'expert opinions'. Ten management guidelines/expert opinions met the inclusion criteria.

EXPERT OPINION:

There was a universal agreement among the articles reviewed, that low-sedating, second-generation antihistamines should be prescribed as a first-line treatment of chronic urticaria. For refractory urticaria, however, recommendations varied and included dose escalation of second-generation antihistamines and adjunctive treatments with other agents of the same class, such as sedating antihistamines or leukotriene receptor antagonists. More research into effective second-line treatments and consistent implementation of current guidelines is needed, to ensure that treatment is based on clinical evidence.

• Authors: Jean-Paul Ortonne
• Journal: Expert opinion on pharmacotherapy (Expert Opin Pharmacother) Vol. 12 Issue 17 Pg. 2683-93 (Dec 2011) ISSN: 1744-7666 [Electronic] England
• PMID: 22035356 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Histamine Antagonists

Topics

• Chronic Disease
• Histamine Antagonists (therapeutic use)
• Humans
• Practice Guidelines as Topic
• Urticaria (drug therapy)