Abstract
Background: Up to 1% of the general population in the USA and Europe suffer from chronic urticaria (CU) at some point in their lifetime. CU has an adverse effect on the quality of life.
Objective: This study aims to provide an update on the epidemiology, pathogenesis, clinical manifestations, diagnosis, aggravating factors, complications, treatment and prognosis of CU.
Methods: The search strategy included meta-analyses, randomized controlled trials, clinical trials, reviews and pertinent references. Patents were searched using the key term "chronic urticaria" at the following links: www.google.com/patents, www.uspto.gov, and www.freepatentsonline.com.
Results: CU is a clinical diagnosis, based on the episodic appearance of characteristic urticarial lesions that wax and wane rapidly, with or without angioedema, on most days of the week, for a period of six weeks or longer. Triggers such as medications, physical stimuli, and stress can be identified in 10 to 20% of cases. C-reactive protein/erythrocyte sedimentation rate, and complete blood cell count with differential are the screening tests that may be used to rule out an underlying disorder. The mainstay of therapy is reassurance, patient education, avoidance of known triggers, and pharmacotherapy. Secondgeneration H1 antihistamines are the drugs of choice for initial therapy because of their safety and efficacy profile. If satisfactory improvement does not occur after 2 to 4 weeks or earlier if the symptoms are intolerable, the dose of second-generation H1 antihistamines can be increased up to fourfold the manufacturer’s recommended dose (all be it off license). If satisfactory improvement does not occur after 2 to 4 weeks or earlier if the symptoms are intolerable after the fourfold increase in the dosage of second-generation H1 antihistamines, omalizumab should be added. If satisfactory improvement does not occur after 6 months or earlier if the symptoms are intolerable after omalizumab has been added, treatment with cyclosporine and second-generation H1 antihistamines is recommended. Short-term use of systemic corticosteroids may be considered for acute exacerbation of CU and in refractory cases. Recent patents for the management of chronic urticaria are also discussed. Complications of CU may include skin excoriations, adverse effect on quality of life, anxiety, depression, and considerable humanistic and economic impacts. On average, the duration of CU is around two to five years. Disease severity has an association with disease duration.
Conclusion: CU is idiopathic in the majority of cases. On average, the duration of CU is around two to five years. Treatment is primarily symptomatic with second generation antihistamines being the first line. Omalizumab has been a remarkable advancement in the management of CU and improves the quality of life beyond symptom control.
Keywords: Angioedema, antihistamines, hives, immunomodulators, pruritus, vasculitis, wheals.
[2]
Juhlin L. Recurrent urticaria: Clinical investigation of 330 patients. Br J Dermatol 1981; 104(4): 369-81.
[3]
Doong JC, Chichester K, Oliver ET, Schwartz LB, Saini SS. Chronic idiopathic urticaria: Systemic complaints and their relationship with disease and immune measures. J Allergy Clin Immunol Pract 2017; 5(5): 1314-8.
[6]
Kudryavtseva AV, Neskorodova KA, Staubach P. Urticaria in children and adolescents: An updated review of the pathogenesis and management. Pediatr Allergy Immunol 2019; 30(1): 17-24.
[7]
Antia C, Baquerizo K, Korman A, Alikhan A, Bernstein JA. Urticaria: A comprehensive review. J Am Acad Dermatol 2018; 79(4): 617-33.
[9]
Leung AKC, Robson WLM. Penile and oral angioedema associated with peanut ingestion. J Natl Med Assoc 2006; 98(12): 2011-2.
[10]
Zuberbier T, Aberer W, Asero R, Abdul Latiff AH, Baker D, Ballmer-Weber B, et al. The EAACI/GA2LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy 2018; 73(7): 1393-414.
[11]
Beck L, Bernstein J, Maurer M. A review of international recommendations for the diagnosis and management of chronic urticaria. Acta Derm Venereol 2008; 97(2): 149-58.
[12]
Buss YA, Garrelfs UC, Sticherling M. Chronic urticaria-which clinical parameters are pathogenetically relevant? A retrospective investigation of 339 patients. J Dtsch Dermatol Ges 2007; 5(1): 22-9.
[13]
Ferrer M. Epidemiology, healthcare, resources, use and clinical features of different types of urticaria. Alergológica 2005. J Investig Allergol Clin Immunol 2009; 19(Suppl. 2): 21-6.
[14]
Hellgren L. The prevalence of urticaria in the total population. Acta Allergol 1972; 27(3): 236-40.
[15]
Lapi F, Cassano N, Pegoraro V, Cataldo N, Heiman F, Cricelli I, et al. Epidemiology of chronic spontaneous urticaria: Results from a nationwide, population-based study in Italy. Br J Dermatol 2016; 174(5): 996-1004.
[16]
Lee N, Lee J-D, Lee H-Y, Kang DR, Ye Y-M. Epidemiology of chronic urticaria in Korea using the Korean health insurance database, 2010-2014. Allergy Asthma Immunol Res 2017; 9(5): 438.
[17]
Lee SJW, Ha EK, Jee HM, Lee KS, Lee SJW, Kim MA, et al. Prevalence and risk factors of urticaria with a focus on chronic urticaria in children. Allergy Asthma Immunol Res 2017; 9(3): 212.
[18]
Maurer M, Abuzakouk M, Bérard F, Canonica W, Oude Elberink H, Giménez-Arnau A, et al. The burden of chronic spontaneous urticaria is substantial: Real-world evidence from ASSURE-CSU. Allergy 2017; 72(12): 2005-16.
[19]
Konstantinou GN, Asero R, Ferrer M, Knol EF, Maurer M, Raap U, et al. EAACI taskforce position paper: Evidence for autoimmune urticaria and proposal for defining diagnostic criteria. Allergy 2013; 68(1): 27-36.
[21]
Confino-Cohen R, Chodick G, Shalev V, Leshno M, Kimhi O, Goldberg A. chronic urticaria and autoimmunity: Associations found in a large population study. J Allergy Clin Immunol 2012; 129(5): 1307-13.
[22]
Sabroe RA, Seed PT, Francis DM, Barr RM, Black AK, Greaves MW. Chronic idiopathic urticaria: Comparison of the clinical features of patients with and without anti-FcepsilonRI or anti-IgE autoantibodies. J Am Acad Dermatol 1999; 40(3): 443-50.
[23]
Kozel MMA, Bossuyt PMM, Mekkes JR, Bos JD. Laboratory tests and identified diagnoses in patients with physical and chronic urticaria and angioedema: A systematic review. J Am Acad Dermatol 2003; 48(3): 409-16.
[24]
Zhong H, Song Z, Chen W, Li H, He L, Gao T, et al. Chronic urticaria in Chinese population: A hospital-based multicenter epidemiological study. Allergy 2014; 69(3): 359-64.
[25]
Kim BR, Yang S, Choi JW, Choi CW, Youn SW. Epidemiology and comorbidities of patients with chronic urticaria in Korea: A nationwide population-based study. J Dermatol 2018; 45(1): 10-6.
[26]
Dias GAC, Pires GV, do Valle SOR, Dortas SD, Levy S, França AT, et al. Impact of chronic urticaria on the quality of life of patients followed up at a university hospital. An Bras Dermatol 2016; 91(6): 754-9.
[27]
Sabroe RA, Fiebiger E, Francis DM, Maurer D, Seed PT, Grattan CEH, et al. Classification of anti-FcepsilonRI and anti-IgE autoantibodies in chronic idiopathic urticaria and correlation with disease severity. J Allergy Clin Immunol 2002; 110(3): 492-9.
[28]
Maurer M, Zuberbier T, Siebenhaar F, Krause K. Chronic urticaria - What does the new guideline tell us? J Dtsch Dermatol Ges 2018; 16(5): 584-93.
[29]
Gruber BL, Baeza ML, Marchese MJ, Agnello V, Kaplan AP. Prevalence and functional role of anti-IgE autoantibodies in urticarial syndromes. J Invest Dermatol 1988; 90(2): 213-7.
[30]
Sahiner UM, Civelek E, Tuncer A, Yavuz ST, Karabulut E, Sackesen C, et al. Chronic urticaria: Etiology and natural course in children. Int Arch Allergy Immunol 2011; 156(2): 224-30.
[31]
Awosika O, Qureshi A, Ehrlich A, Fonacier L. Chronic
urticaria" Recommendations from an allergist and
immunologist. Dermat contact, atopic, Occup drug 2018; 29(5): 292-3.
[32]
Kaplan AP. Chronic urticaria: Pathogenesis and treatment. J Allergy Clin Immunol 2004; 114(3): 465-74.
[33]
Leznoff A, Sussman GL. Syndrome of idiopathic chronic urticaria and angioedema with thyroid autoimmunity: A study of 90 patients. J Allergy Clin Immunol 1989; 84(1): 66-71.
[34]
Kim YS, Han K, Lee JH, Kim NI, Roh JY, Seo SJ, et al. Increased risk of chronic spontaneous urticaria in patients with autoimmune thyroid diseases: A nationwide, population-based study. Allergy Asthma Immunol Res 2017; 9(4): 373-7.
[35]
Sánchez Jorge J, Sánchez A, Cardona R. Prevalence of drugs as triggers of exacerbations in chronic urticaria. J Investig Allergol Clin Immunol 2018.
[http://dx.doi.org/10.18176/jiaci.0287]
[http://dx.doi.org/10.18176/jiaci.0287]
[36]
Zinelli C, Caffarelli C, Strid J, Jaffe A, Atherton DJ. Measurement of nitric oxide and 8-isoprostane in exhaled breath of children with atopic eczema. Clin Exp Dermatol 2009; 34(5): 607-12.
[37]
Powell RJ, Leech SC, Till S, Huber PAJ, Nasser SM, Clark AT, et al. BSACI guideline for the management of chronic urticaria and angioedema. Clin Exp Allergy 2015; 45(3): 547-65.
[38]
Schaefer P. Acute and Chronic urticaria: Evaluation and treatment. Am Fam Physician 2017; 95(11): 717-24.
[39]
Shalom G, Magen E, Babaev M, Horev A, Freud T, Ben Yakov G, et al. Chronic urticaria and irritable bowel syndrome: A cross-sectional study of 11 271 patients. Br J Dermatol 2018; 178(3): e204-6.
[40]
Larenas-Linnemann D, Saini SS, Azamar-Jácome AA, Maurer M. Chronic urticaria can be caused by cancer and resolves with its cure. Allergy 2018; 73(7): 1562-6.
[42]
Yu JR, Leslie KS. Cryopyrin-associated periodic syndrome: An update on diagnosis and treatment response. Curr Allergy Asthma Rep 2011; 11(1): 12-20.
[43]
Kile RL, Rusk HA. A case of cold urticaria with an unusual family history. J Am Med Assoc 1940; 114(12): 1067-8.
[44]
Stych B, Dobrovolny D. Familial cold auto-inflammatory syndrome (FCAS): Characterization of symptomatology and impact on patients’ lives. Curr Med Res Opin 2008; 24(6): 1577-82.
[45]
Montealegre Sanchez GA, Hashkes PJ. Neurological manifestations of the Mendelian-inherited autoinflammatory syndromes. Dev Med Child Neurol 2009; 51(6): 420-8.
[46]
Muckle TJ, Well SM. Urticaria, deafness, and amyloidosis: A new heredo-familial syndrome. Q J Med 1962; 31: 235-48.
[47]
Kilcline C, Shinkai K, Bree A, Modica R, Von Scheven E, Frieden IJ. Neonatal-onset multisystem inflammatory disorder: The emerging role of pyrin genes in autoinflammatory diseases. Arch Dermatol 2005; 141(2): 248-53.
[48]
Leslie KS, Lachmann HJ, Bruning E, McGrath JA, Bybee A, Gallimore JR, et al. Phenotype, genotype, and sustained response to anakinra in 22 patients with autoinflammatory disease associated with CIAS-1/NALP3 mutations. Arch Dermatol 2006; 142(12): 1591-7.
[50]
Ciccarelli F, De Martinis M, Ginaldi L. An update on autoinflammatory diseases. Curr Med Chem 2014; 21(3): 261-9.
[51]
Joint task force on practice parameters. The diagnosis and management of urticaria: A practice parameter part I: Acute urticaria/angioedema part II: Chronic urticaria/angioedema. Joint task force on practice parameters. Ann Allergy Asthma Immunol 2000; 85(6 Pt 2): 521-44.
[52]
DeShazo RD, Kemp SF. Allergic reactions to drugs and biologic agents. JAMA 1997; 278(22): 1895-906.
[53]
Kasumagic-Halilovic E, Beslic N, Ovcina-Kurtovic N. Thyroid autoimmunity in patients with chronic urticaria. Med Arch
(Sarajevo, Bosnia Herzegovina) 2017; 71(1): 29-31.
[54]
Maurer M, Church MK, Weller K. Chronic urticaria in children: Still itching for insight. JAMA Dermatology 2017; 153(12): 1221-2.
[55]
Hermes B, Prochazka AK, Haas N, Jurgovsky K, Sticherling M, Henz BM. Upregulation of TNF-alpha and IL-3 expression in lesional and uninvolved skin in different types of urticaria. J Allergy Clin Immunol 1999; 103(2 Pt 1): 307-14.
[56]
Lourenço FD, Azor MH, Santos JC, Prearo E, Maruta CW, Rivitti EA, et al. Activated status of basophils in chronic urticaria leads to interleukin-3 hyper-responsiveness and enhancement of histamine release induced by anti-IgE stimulus. Br J Dermatol 2008; 158(5): 979-86.
[57]
Kulthanan K, Tuchinda P, Chularojanamontri L, Chanyachailert P, Korkij W, Chunharas A, et al. Clinical practice guideline for diagnosis and management of urticaria. Asian Pac J Allergy Immunol 2016; 34(3): 190-200.
[58]
Fine LM, Bernstein JA. Urticaria guidelines: Consensus and controversies in the European and American guidelines. Curr Allergy Asthma Rep 2015; 15(6): 30.
[59]
Bernstein JA, Lang DM, Khan DA, Craig T, Dreyfus D, Hsieh F, et al. The diagnosis and management of acute and chronic urticaria: 2014 Update. J Allergy Clin Immunol 2014; 133(5): 1270-7.
[60]
Dreskin SC, Andrews KY. The thyroid and urticaria. Curr Opin Allergy Clin Immunol 2005; 5(5): 408-12.
[61]
Kozel MMA, Ansari Moein MC, Mekkes JR, Meinardi MMHM, Bossuyt PMM, Bos JD. Evaluation of a clinical guideline for the diagnoses of physical and chronic urticaria and angioedema. Acta Derm Venereol 2002; 82(4): 270-4.
[62]
Gaig P, Olona M, Muñoz Lejarazu D, Caballero MT, Domínguez FJ, Echechipia S, et al. Epidemiology of urticaria in Spain. J Investig Allergol Clin Immunol 2004; 14(3): 214-20.
[63]
Ben-Shoshan M, Grattan CE. Management of pediatric urticaria with review of the literature on chronic spontaneous urticaria in children. J Allergy Clin Immunol Pract 2018.
[64]
Hochstadter EF, Ben-Shoshan M. Cold-induced urticaria: Challenges in diagnosis and management. BMJ Case Rep 2013.
[65]
Marzano AV, Tavecchio S, Venturini M, Sala R, Calzavara-Pinton P, Gattorno M. Urticarial vasculitis and urticarial autoinflammatory syndromes. G Ital Dermatol Venereol 2015; 150(1): 41-50.
[66]
Kolkhir P, Pogorelov D, Olisova O. CRP, D-dimer, fibrinogen and ESR as predictive markers of response to standard doses of levocetirizine in patients with chronic spontaneous urticaria. Eur Ann Allergy Clin Immunol 2017; 49(4): 189-92.
[67]
Kolkhir P, Altrichter S, Hawro T, Maurer M. C-reactive protein is linked to disease activity, impact, and response to treatment in patients with chronic spontaneous urticaria. Allergy 2018; 73(4): 940-8.
[68]
Llamas-Velasco M, Fraga J, Requena L, Sánchez-Pérez J, Merino EO, García-Diez A. Urticaria with inflammatory infiltrate predominantly neutrophilic or neutrophilic urticaria. Study of its clinical and histopathological characteristics and its possible association with rheumatologic disease. Actas Dermosifiliogr 2012; 103(6): 511-9.
[70]
Criado PR, Criado RFJ, Maruta CW, dos Reis VMS. dos. Chronic urticaria in adults: State-of-the-art in the new millennium. An Bras Dermatol 2015; 90(1): 74-89.
[71]
Wittig HJ, Belloit J, De IF, Royal G. Age-related serum immunoglobulin E levels in healthy subjects and in patients with allergic disease. J Allergy Clin 1980; 66(4): 305-13.
[72]
Takahagi S, Mihara S, Iwamoto K, Morioke S, Okabe T, Kameyoshi Y, et al. Coagulation/fibrinolysis and inflammation markers are associated with disease activity in patients with chronic urticaria. Allergy 2010; 65(5): 649-56.
[73]
Rojanapremsuk T, Kasprowicz S, Schafer E, Story R, Clarke MS, Walls T, et al. Clinicopathologic findings in (anti-FcepsilonR1alpha) autoimmune-related chronic urticaria. J Cutan Pathol 2015; 42(5): 329-32.
[74]
Ulambayar B, Chen Y-H, Ban G-Y, Lee J-H, Jung C-G, Yang E-M, et al. Detection of circulating IgG autoantibody to FcεRIα in sera from chronic spontaneous urticaria patients. J Microbiol Immunol Infect 2017.
[http://dx.doi.org/10.1016/j.jmii.2017.10.003]
[http://dx.doi.org/10.1016/j.jmii.2017.10.003]
[75]
Maouia A, Youssef M, Leban N, Ben Chibani J, Helal AN, Kassab A. CRP relevance in clinical assessment of chronic spontaneous urticaria Tunisian patients. Cutan Ocul Toxicol 2017; 36(4): 387-92.
[76]
Cherrez-Ojeda I, Robles-Velasco K, Bedoya-Riofrío P, Schmid-Grendelmeier P, Cherrez S, Colbatzky F, et al. Checklist for a complete chronic urticaria medical history: An easy tool. World Allergy Organ J 2017; 10(1): 34.
[77]
Itakura A, Tani Y, Kaneko N, Hide M. Impact of chronic urticaria on quality of life and work in Japan: Results of a real-world study. J Dermatol 2018; 45(8): 963-70.
[78]
Kozel MM, Mekkes JR, Bossuyt PM, Bos JD. Natural course of physical and chronic urticaria and angioedema in 220 patients. J Am Acad Dermatol 2001; 45(3): 387-91.
[79]
Curto-Barredo L, Archilla L, Vives G, Pujol R, Giménez-Arnau A. Clinical features of chronic spontaneous urticaria that predict disease prognosis and refractoriness to standard treatment. Acta Derm Venereol 2018; 98(7): 641-7.
[80]
Antia C, Baquerizo K, Korman A, Alikhan A, Bernstein JA. Urticaria: A comprehensive review: Treatment of chronic urticaria, special populations, and disease outcomes. J Am Acad Dermatol 2018; 79(4): 617-33.
[81]
Siles R, Xu M, Hsieh FH. The utility of serum tryptase as a marker in chronic spontaneous urticaria. Acta Derm Venereol 2013; 93(3): 354-5.
[82]
Netchiporouk E, Sasseville D, Moreau L, Habel Y, Rahme E, Ben-Shoshan M. Evaluating comorbidities, natural history, and predictors of early resolution in a cohort of children with chronic urticaria. JAMA Dermatol 2017; 153(12): 1236-42.
[83]
Nebiolo F, Bergia R, Bommarito L, Bugiani M, Heffler E, Carosso A, et al. Effect of arterial hypertension on chronic urticaria duration. Ann Allergy Asthma Immunol 2009; 103(5): 407-10.
[84]
Sánchez-Borges M, Caballero-Fonseca F, Capriles-Hulett A, González-Aveledo L, Maurer M. Factors linked to disease severity and time to remission in patients with chronic spontaneous urticaria. J Eur Acad Dermatol Venereol 2017; 31(6): 964-71.
[85]
Singh-Franco D, Ghin HL, Robles GI, Borja-Hart N, Perez A. Levocetirizine for the treatment of allergic rhinitis and chronic idiopathic urticaria in adults and children. Clin Ther 2009; 31(8): 1664-87.
[86]
Zuberbier T, Balke M, Worm M, Edenharter G, Maurer M. Epidemiology of urticaria: A representative cross-sectional population survey. Clin Exp Dermatol 2010; 35(8): 869-73.
[87]
Labrador-Horrillo M, Ferrer M. Profile of omalizumab in the treatment of chronic spontaneous urticaria. Drug Des Devel Ther 2015; 9: 4909.
[88]
Kaplan AP. Therapy of chronic urticaria: A simple, modern approach. Ann Allergy Asthma Immunol 2014; 112(5): 419-25.
[89]
Zuberbier T, Aberer W, Asero R, Bindslev-Jensen C, Brzoza Z, Canonica GW, et al. The EAACI/GA(2) LEN/EDF/WAO guideline for the definition, classification, diagnosis, and management of urticaria: The 2013 revision and update. Allergy 2014; 69(7): 868-87.
[90]
Blanca RDP. Chronic urticaria in children: A review Available at: https://www.emjreviews.com/dermatology/article/chronic-urticaria-in-children-a-review/
[91]
Licari A, Marseglia A, Caimmi S, Castagnoli R, Foiadelli T, Barberi S, et al. Omalizumab in children. Paediatr Drugs 2014; 16(6): 491-502.
[92]
Maurer M, Rosén K, Hsieh H-J, Saini S, Grattan C, Gimenéz-Arnau A, et al. Omalizumab for the treatment of chronic idiopathic or spontaneous urticaria. N Engl J Med 2013; 368(10): 924-35.
[93]
Cordeiro Moreira AS, Rosmaninho Lopes de Soares E, Silva MI. Pereira Guilherme MA, Da Silva Ferreira JA, Fonseca Moreira da Silva JP. Use of omalizumab in the treatment of chronic urticaria. Eur Ann Allergy Clin Immunol 2016; 48(6): 242-6.
[94]
Brinkhaus B, Ortiz M, Witt CM, Roll S, Linde K, Pfab F, et al. Acupuncture in patients with seasonal allergic rhinitis: A randomized trial. Ann Intern Med 2013; 158(4): 225-34.
[95]
Zuberbier T. A summary of the new international EAACI/GA2LEN/EDF/WAO guidelines in urticaria. World Allergy Organ J 2012; 5(Suppl. 1): S1-5.
[96]
Sharma M, Bennett C, Cohen SN, Carter B. H1-antihistamines for chronic spontaneous urticaria. Cochrane Database Syst Rev 2014; (11): CD006137
[97]
Lee XHM, Ong LX, Cheong JYV, Sultana R, Rao R, Lim HH, et al. A stepwise approach in the management of chronic spontaneous urticaria in children. Asia Pac Allergy 2016; 6(1): 16-28.
[98]
Lee XHM, Ong LX, Cheong JYV, Sultana R, Rao R, Lim HH, et al. No Tit A stepwise approach in the management of chronic spontaneous urticaria in children. Asia Pac Allergy 2016; 6(1): 16-28.
[99]
Uysal P, Avcil S, Erge D. High-dose anti-histamine use and risk factors in children with urticaria. Türk Pediatri Arşivi 2016; 51(4): 198-203.
[100]
Choi SH, Baek HS. Approaches to the diagnosis and management of chronic urticaria in children. Korean J Pediatr 2015; 58(5): 159-64.
[101]
Erbagci Z. The leukotriene receptor antagonist montelukast in the treatment of chronic idiopathic urticaria: A single-blind, placebo-controlled, crossover clinical study. J Allergy Clin Immunol 2002; 110(3): 484-8.
[102]
Pacor ML, Di Lorenzo G, Corrocher R. Efficacy of leukotriene receptor antagonist in chronic urticaria. A double-blind, placebo-controlled comparison of treatment with montelukast and cetirizine in patients with chronic urticaria with intolerance to food additive and/or acetylsalicylic acid. Clin Exp Allergy 2001; 31(10): 1607-14.
[103]
De Silva N, Damayanthi H, Rajapakse A, Rodrigo C, Rajapakse S. Leukotriene receptor antagonists for chronic urticaria: A systematic review. Allergy Asthma Clin Immunol 2014; 10(1): 24.
[104]
Pite H, Wedi B, Borrego LM, Kapp A, Raap U. Management of childhood urticaria: Current knowledge and practical recommendations. Acta Derm Venereol 2013; 93(5): 500-8.
[105]
Sokol KC, Amar NK, Starkey J, Grant JA. Ketotifen in the management of chronic urticaria: Resurrection of an old drug. Ann Allergy Asthma Immunol 2013; 111(6): 433-6.
[107]
Zhao Z-T, Ji C-M, Yu W-J, Meng L, Hawro T, Wei J-F, et al. Omalizumab for the treatment of chronic spontaneous urticaria: A meta-analysis of randomized clinical trials. J Allergy Clin Immunol 2016; 137(6): 1742-1750.e4.
[108]
Giménez-Arnau AM, Toubi E, Marsland AM, Maurer M. Clinical management of urticaria using omalizumab: The first licensed biological therapy available for chronic spontaneous urticaria. J Eur Acad Dermatol Venereol 2016; 30(Suppl. 5): 25-32.
[109]
Netchiporouk E, Nguyen CH, Thuraisingham T, Jafarian F, Maurer M, Ben-Shoshan M. Management of pediatric chronic spontaneous and physical urticaria patients with omalizumab: Case series. Pediatr Allergy Immunol 2015; 26(6): 585-8.
[110]
Holgate ST, Djukanovic R, Casale T, Bousquet J, Djukanović R, Casale T, et al. Anti-immunoglobulin E treatment with omalizumab in allergic diseases: An update on anti-inflammatory activity and clinical efficacy. Clin Exp Allergy 2005; 35(4): 408-16.
[111]
Maurer M, Abuzakouk M, Bérard F, Canonica W, Oude Elberink H, Giménez-Arnau A, et al. The burden of chronic spontaneous urticaria is substantial: Real-world evidence from ASSURE-CSU. Allergy 2017; 72(12): 2005-16.
[112]
Bradley JS, Byington CL, Shah SS, Alverson B, Carter ER, Harrison C, et al. The management of community-acquired pneumonia in infants and children older than 3 months of age: Clinical practice guidelines by the pediatric infectious diseases society and the infectious diseases society of America. Clin Infect Dis 2011; 53(7): e25-76.
[113]
Kaplan AP. What the first 10,000 patients with chronic urticaria have taught me: A personal journey. J Allergy Clin Immunol 2009; 123(3): 713-7.
[114]
Ohtsuka T. Response to oral cyclosporine therapy and high sensitivity-CRP level in chronic idiopathic urticaria. Int J Dermatol 2010; 49(5): 579-84.
[115]
Doshi DR, Weinberger MM. Experience with cyclosporine in children with chronic idiopathic urticaria. Pediatr Dermatol 2009; 26(4): 409-13.
[116]
Marchese ML, Eimer L, Stringa O. Ciclosporin and its use in dermatology: Introduction. Arch Argent Dermatol 2014; 64(3): 89-97.
[117]
Kim S, Baek S, Shin B, Yoon S, Park SY, Lee T, et al. Influence of initial treatment modality on long-term control of chronic idiopathic urticaria. PLoS One 2013; 8(7)e69345
[118]
Maurer M, Magerl M, Metz M, Zuberbier T. Revisions to the international guidelines on the diagnosis and therapy of chronic urticaria. J Dtsch Dermatol Ges 2013; 11(10): 971-7.
[119]
Kurt E, Bavbek S, Pasaoglu G, Abadoglu O, Misirligil Z. Use of alternative medicines by allergic patients in Turkey. Allergol Immunopathol (Madr) 2004; 32(5): 289-94.
[120]
Morgan M. Treatment of refractory chronic urticaria with sirolimus. Arch Dermatol 2009; 145(6): 637-9.
[121]
Shahar E, Bergman R, Guttman-Yassky E, Pollack S. Treatment of severe chronic idiopathic urticaria with oral mycophenolate mofetil in patients not responding to antihistamines and/or corticosteroids. Int J Dermatol 2006; 45(10): 1224-7.
[122]
Sönnichsen A, Saulite I, Mangana J, Kerl K, Mehra T, Desislava I, et al. Interleukin-1 receptor antagonist (anakinra) for Schnitzler syndrome. J Dermatolog Treat 2016; 27(5): 436-8.
[123]
Néel A, Henry B, Barbarot S, Masseau A, Perrin F, Bernier C, et al. Long-term effectiveness and safety of interleukin-1 receptor antagonist (anakinra) in Schnitzler’s syndrome: A french multicenter study. Autoimmun Rev 2014; 13(10): 1035-41.
[124]
Dworetzky SI, Hebrank GT, Archibald DG, Reynolds IJ, Farwell W, Bozik ME. The targeted eosinophil-lowering effects of dexpramipexole in clinical studies. Blood Cells Mol Dis 2017; 63: 62-5.
[125]
Koné-Paut I, Piram M. Targeting interleukin-1β in CAPS (Cryopyrin-Associated Periodic) syndromes. Autoimmun Rev 2012; 12(1): 77-80.
[126]
Georgin-Lavialle S, Fayand A, Rodrigues F, Bachmeyer C, Savey L, Grateau G. Autoinflammatory diseases: State of the art. Presse Med 2019.
[127]
Imagawa T, Nishikomori R, Takada H, Takeshita S, Patel N, Kim D, et al. Safety and efficacy of canakinumab in Japanese patients with phenotypes of cryopyrin-associated periodic syndrome as established in the first open-label, phase-3 pivotal study (24-week results). Clin Exp Rheumatol 2019; 31(2): 302-9.
[129]
Vairo GL, Hamilton JA, Cook AD. Treatment of chronic
inflammatory conditions. US20150017180 (2015).
[130]
Bozik ME, Dworetzky S. Compositions and methods for treating
chronic urticaria. US20160193186 (2016).
[131]
Bozik ME, Dworetzky S. Compositions and methods for treating
chronic urticaria. US20180015073 (2018).
[132]
Alpan O, Enav BI. Therapy for chronic idiopathic urticaria,
anaphylaxis and angioedema. US20160271112 (2016).
[133]
Chen C, Lee J, Lu W, Brown CO. Methods for inhibiting
expression of asc, expression of NLRP3, and/or formation of
NLRP3 inflammasome complex using diacerein or its analogs.
US20170049733 (2017).
Related Journals
Current Medicinal Chemistry
Current Pharmaceutical Design
Current Topics in Medicinal Chemistry
Current Respiratory Medicine Reviews
Infectious Disorders - Drug Targets
Endocrine, Metabolic & Immune Disorders - Drug Targets
Anti-Infective Agents
Coronaviruses
Recent Advances in Inflammation & Allergy Drug Discovery
Current Probiotics
Related Books
The NLRP3 Inflammasome: An Attentive Arbiter of Inflammatory Response
Natural Immunomodulators: Promising Therapy for Disease Management
Herbal Immunity Boosters Against COVID-19
Mitochondrial DNA and the Immuno-inflammatory Response: New Frontiers to Control Specific Microbial Diseases
Frontiers in Clinical Drug Research – Anti Allergy Agents
Frontiers in Inflammation
Article Metrics
101
21
1
1