Management of chronic urticaria in Asia: 2010 AADV consensus guidelines

Chow, Sam

doi:10.5415/apallergy.2012.2.2.149

Cited by 33 publications

(28 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A typical dose of 150 mg every 2nd/4th week or 300 mg/month for 4–6 doses can have lasting efficacy of up to 15 months with significant improvement in QoL [65–67]. The significant downside is the high cost associated with the treatment (1-2 subcutaneous injections/month at US $10,000/year) and its yet unknown side effects with regard to parasitic infectious disease burden with its use in India or Asia [68–70]. …”

Section: Treatment Optionsmentioning

confidence: 99%

Chronic Urticaria: Indian Context—Challenges and Treatment Options

Khan

Maitra²,

Hissaria

et al. 2013

Dermatology Research and Practice

View full text Add to dashboard Cite

Urticaria is a common condition that occurs in both children and adults. Most cases have no specific allergic trigger and the aetiology of urticaria remains idiopathic and occasionally spontaneous in nature. Inappropriate advice such as avoidance of foods (milk, egg, prawn, and brinjal) is common place in certain sections of India mostly by nonspecialists that should not be routinely recommended. It is important to look for physical urticarias such as pressure urticaria in chronic cases, which may be present either alone or in combination with other causes. Autoimmune causes for chronic urticaria have been found to play an important role in a significant proportion of patients. Long-acting nonsedating antihistamines at higher than the standard doses is safe and effective. Quality of life is affected adversely in patients with chronic symptomatic urticaria and some may require multidisciplinary management.

show abstract

Section: Treatment Optionsmentioning

confidence: 99%

Chronic Urticaria: Indian Context—Challenges and Treatment Options

Khan

Maitra²,

Hissaria

et al. 2013

Dermatology Research and Practice

View full text Add to dashboard Cite

show abstract

“…It also states that if standard dosing is not effective, increasing the dosage up to fourfold is recommended. This recommendation is reiterated in other, newer international guidelines …”

mentioning

confidence: 91%

Night‐time sedating H ₁ ‐antihistamine increases daytime somnolence but not treatment efficacy in chronic spontaneous urticaria: a randomized controlled trial

et al. 2014

View full text Add to dashboard Cite

BackgroundMany physicians believe that the most effective way to treat chronic urticaria is to take a nonsedating second-generation H1-antihistamine in the morning and a sedating first-generation H1-antihistamine, usually hydroxyzine, at night to enhance sleep. But is this belief well founded?ObjectivesTo test this belief by comparing the effectiveness and prevalence of unwanted sedative effects when treating patients with chronic spontaneous urticaria (CSU) with levocetirizine 15 mg daily plus hydroxyzine 50 mg at night (levocetirizine plus hydroxyzine) vs. levocetirizine 20 mg daily (levocetirizine monotherapy).MethodsIn this randomized, double-blind, cross-over study, 24 patients with difficult-to-treat CSU took levocetirizine plus hydroxyzine or levocetirizine monotherapy for periods of 5 days each. At the end of each treatment period, assessments were made of quality of life (Chronic Urticaria Quality of Life Questionnaire, CU-Q2oL), severity of urticaria symptoms (Urticaria Activity Score, UAS), sleep disturbance during the night and daytime somnolence.ResultsBoth treatments significantly decreased UAS, night-time sleep disturbances and CU-Q2oL scores (P < 0·001) without significant differences between the two. Compared with baseline, daytime somnolence was significantly reduced by levocetirizine monotherapy (P = 0·006) but not by levocetirizine plus hydroxyzine (P = 0·218). Direct comparison of the two treatment modalities in terms of daytime somnolence favoured levocetirizine monotherapy (P = 0·026).ConclusionsThe widespread belief that sleep is aided by the addition of a sedating first-generation H1-antihistamine, usually hydroxyzine, at night is not supported. These results are in line with the urticaria guidelines, which state that first-line treatment for urticaria should be new-generation, nonsedating H1-antihistamines only.

show abstract

“…Guidelines have been developed for managing chronic urticaria in adults, and recent randomized controlled trials (RCTs) of omalizumab included teenagers from 12 to 18 years old . However, there are no specific guidelines for children under age 12.…”

Section: Introductionmentioning

confidence: 99%