FCAAIA Notes: Chronic urticaria (hives present for 6 week or longer) is a frustrating problem although it is usually a completely benign condition. It is rarely from an identifiable and avoidable trigger. Antihistamines are the main stay of treatment but many patients do not so well enough with only one dose a day. Current guidelines for the care of chronic urticaria all agree that the doses may be pushed to 4 times the labelled dose. Frequently, patients need to “mix and match” to find the combination that works best for them, as there is never an antihistamine that is always best. Continue reading “ANTIHISTAMINE UPDOSING IN CHRONIC URTICARIA – IS THERE ENOUGH EVIDENCE?”
FCAAIA Notes: Chronic urticaria (hives) are those present for 6 weeks or longer. Unfortunately, the vast majority of chronic urticaria are “idiopathic” (CIU). That is, they do not have an identifiable and avoidable trigger. Collectively, these are called chronic spontaneous urticaria (CSU)
CSU is a completely benign condition with exception of its impact on quality of life. Itch probably has the greatest impact on quality of life as it can result in sleep disturbance and loss of productivity at work and school and the unsightly appearance results in absenteeism for work and school. Continue reading “THE BURDEN OF CHRONIC SPONTANEOUS URTICARIA IS SUBSTANTIAL: REAL‐WORLD EVIDENCE FROM ASSURE‐CSU”
FCAAIA Notes: Several months ago, I posted an article announcing that the FDA approved omalizumab for the treatment of chronic idiopathic urticaria (hives). Rather than repeat my commentary here, I refer the reader to it for review.
This study is among those that supports the FDA’s decision and supports the most recent published guideline’s recommendation for treatment with omalizumab in recalcitrant chronic idiopathic urticaria. But, omalizumab is not a first line treatment Continue reading “OMALIZUMAB EFFECTIVE FOR CHRONIC HIVES UP TO 24 WEEKS”
FCAAIA Notes: Omalizumab is a humanized murine (mouse) monoclonal antibody against IgE, the immunoglobulin associated with allergies. About 1/3 of patients with chronic idiopathic urticaria (CIU, hives lasting at least 6 weeks that do not have any other identifiable cause) make an antibody to the receptor for IgE that sits on the surface of cells called mast cells that are found (among other places) ion the skin). Activated mast cells release histamine and other chemicals (that’s why ANTI-histamines are used in allergies). Omalizumab helps prevent mast cell activation by preventing IgE from binding to its receptor. Until now, it only had FDA approval for asthma.
Patients with CIU should still be treated with antihistamines first. Continue reading “FDA OKS OMALIZUMAB (XOLAIR) FOR CHRONIC HIVES”