Insights and advances in chronic urticaria: a Canadian perspective

Review

Gordon Sussman^1*, Jacques Hébert², Wayne Gulliver³, Charles Lynde¹, Susan Waserman⁴, Amin Kanani⁵, Moshe Ben-Shoshan⁶, Spencer Horemans¹, Carly Barron¹,Stephen Betschel¹, William H Yang⁷, Jan Dutz⁵, Neil Shear¹, Gina Lacuesta⁸, Peter Vadas¹, Kenneth Kobayashi⁷, Hermenio Lima⁴ and F Estelle R Simons⁹

Allergy, Asthma & Clinical Immunology 2015, 11:7  doi:10.1186/s13223-015-0072-2

Abstract

In the past few years there have been significant advances which have changed the face of chronic urticaria. In this review, we aim to update physicians about clinically relevant advances in the classification, diagnosis and management of chronic urticaria that have occurred in recent years.

These include clarification of the terminology used to describe and classify urticaria. We also detail the development and validation of instruments to assess urticaria and understand the impairment on quality-of-life and the morbidity caused by this disease. Additionally, the approach to management of chronic urticaria now focuses on evidence-based use of non-impairing, non-sedating H1-antihistamines given initially in standard doses and if this is not effective, in up to 4-fold doses. For urticaria refractory to H1-antihistamines, omalizumab treatment has emerged as an effective, safe option.

Keywords: 

Chronic urticaria; Diagnosis; Classification; Management; Immunology; Antihistamines; Up-dosing; Omalizumab 

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