Treatment options in refractory chronic spontaneous urticaria.

IF 3 4区医学 Q2 ALLERGY Current Opinion in Allergy and Clinical Immunology Pub Date : 2024-10-01 Epub Date: 2024-06-19 DOI:10.1097/ACI.0000000000001006

Yashdeep Singh Pathania

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Abstract

Purpose of review: Chronic spontaneous urticaria (CSU) patients sometimes do not respond to second-generation antihistamine, and 10-50% patients do not even respond to four-fold the usual dose of nonsedating H1 antihistamine, which further leads to repeated courses of oral corticosteroids to abate the symptoms. There are third-line agents approved by EAACI guidelines, which include omalizumab and cyclosporine. Certain patients are even resistant to the third-line agents. In this review, various other treatment options will be discussed in patients of refractory CSU.

Recent findings: Recently, we demonstrated azathioprine as a possible third-line option, which was found noninferior to cyclosporine in antihistamine refractory CSU. There have been trials, studies, case series and reports, which suggest other putative options for refractory CSU management.

Summary: Studies on the management of refractory CSU are accumulating thereby expanding the armamentarium of dermatologists and allergologist against difficult-to-treat urticaria patients.

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难治性慢性自发性荨麻疹的治疗方案。

审查目的：慢性自发性荨麻疹（CSU）患者有时对第二代抗组胺药无反应，10%-50%的患者甚至对四倍于常规剂量的非致敏H1抗组胺药无反应，这进一步导致患者需要反复口服皮质类固醇激素来缓解症状。EAACI指南批准的三线药物包括奥马珠单抗和环孢素。某些患者甚至对三线药物产生耐药性。本综述将讨论难治性 CSU 患者的其他各种治疗方案：最近，我们证明硫唑嘌呤是一种可能的三线选择，在抗组胺药难治性CSU患者中，硫唑嘌呤的疗效并不优于环孢素。小结：有关难治性CSU治疗的研究正在不断积累，从而扩大了皮肤科医生和过敏科医生应对难治性荨麻疹患者的手段。

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来源期刊

Current Opinion in Allergy and Clinical Immunology 医学-过敏

CiteScore

5.90

自引率

3.60%

发文量

109

审稿时长

6-12 weeks

期刊介绍： This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on one to three topics, every issue of Current Opinion in Allergy and Clinical Immunology delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as upper airway disease; mechanisms of allergy and adult asthma; paediatric asthma and development of atopy; food and drug allergies; and immunotherapy.

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