Use of nonbiologic treatments in antihistamine-refractory chronic urticaria: a review of published evidence

The Journal of Dermatological Treatment
Jesper Grønlund HolmSimon Francis Thomsen

Abstract

Knowledge of effectiveness and safety of the nonbiologic, nonantihistamine treatments used for chronic urticaria is important as in some cases the principal guideline-recommended drug; omalizumab, has limited effect, side effects or is too expensive or unavailable. Herein, we systematically review the evidence for the use of the nonbiologic treatments in antihistamine-refractory chronic urticaria. We performed a systematic review of the literature using PubMed and Webofscience and identified studies that reported use of one or more of the nonbiological, nonantihistamine treatment options for chronic urticaria. The studies were evaluated based on study design, number of patients, effect of treatment and safety. We identified 118 studies or case series with 13 different treatments (azathioprine, chloroquine, colchicine, cyclosporine, dapsone, intravenous immunoglobulin (IVIG), methotrexate, montelukast, mycophenolate mofetil, plasmapheresis, sulfasalazine, tranexamic acid and ultraviolet light (UV) A, UVB) totaling 1682 patients. There was a paucity of controlled trials for most of the treatments reviewed albeit the strongest evidence in favor of a beneficial effect in chronic urticaria was, apart from montelukast and cyclosporin...Continue Reading

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Citations

Jan 10, 2020·Dermatologic Therapy·Jesper Grønlund HolmSimon Francis Thomsen
Jun 12, 2021·The Journal of Allergy and Clinical Immunology. in Practice·David A KhanEmel Aygören-Pürsün
Aug 7, 2021·Curēus·Salim Alkeraye, Danah K AlRuhaimi
Sep 17, 2021·Clinical Reviews in Allergy & Immunology·Liting HeQianjin Lu
Sep 12, 2019·Dermatology : International Journal for Clinical and Investigative Dermatology·Florian AnzengruberReinhard Dummer

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