Table 1. Treatments for Chronic Urticaria [89, 97, 98].
Step 1 | ➢ Establish a diagnosis. Reassurance, patient education, avoidance of known triggers | [10, 89, 97, 98] |
➢ Second-generation H1 antihistamines | ||
Step 2 | ➢ Optimize dosages of second-generation H1 antihistamines ➢ Adding another second-generation H1 antihistamine, or a leukotriene receptor antagonist such as montelukast |
[10, 11, 89, 97, 98] |
Step 3 | ➢ Increase the dose of potent first-generation H1 antihistamines such as or doxepin and hydroxyzine and titrating the dose as tolerated ➢ Any medications that did not seem to work should be discontinued |
[10, 11, 89, 97] |
Step 4 | ➢ Omalizumab, cyclosporin, corticosteroid, etc. | [10, 28, 89, 97, 98] |
➢ Once CU is controlled, “step-down” in treatment is recommended ➢ Second-generation H1 antihistamines may be withdrawn periodically to identify spontaneous remission of the disease ➢ CU should be treated until spontaneous remission occurs |
Current and future potential treatments for chronic urticaria.