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The KAAACI/KDA Evidence-Based Practice Guidelines for Chronic Spontaneous Urticaria in Korean Adults and Children: Part 2. Management of H1-Antihistamine-Refractory Chronic Urticaria
- The KAAACI/KDA Evidence-Based Practice Guidelines for Chronic Spontaneous Urticaria in Korean Adults and Children: Part 2. Management of H1-Antihistamine-Refractory Chronic Urticaria
- Choi, Jeong-Hee; Lee, Dong Hun; Song, Woo-Jung; Choi, Mira; Kwon, Jae-Woo; Kim, Gun-Woo; Kim, Myung Hwa; Kim, Mi-Ae; Kim, Min-Hye; Kim, Byung-Keun; Kim, Sujeong; Kim, Joung Soo; Kim, Jung Eun; Kim, Ju-Young; Kim, Joo-Hee; Kim, Hyun Jung; Kim, Hye One; Kim, Hyo-Bin; Roh, Joo Young; Park, Kyung Hee; Park, Kui Young; Park, Han-Ki; Park, Hyunsun; Bae, Jung Min; Byun, Ji Yeon; Song, Dae Jin; Ahn, Young Min; Lee, Seung Eun; Lee, Young Bok; Lee, Joong Sun; Lee, Ji Hyun; Lim, Kyung-Hwan; Youn, Sang Woong; Chang, Yoon-Seok; Jeon, You Hoon; Jeon, Jiehyun; Jue, Mihn-Sook; Choi, Sun Hee; Hur, Gyu-Young; Lim, Dae Hyun; Ye, Young-Min; Park, Young Min
- Ewha Authors
- 변지연; 김민혜
- SCOPUS Author ID
- Issue Date
- Journal Title
- ALLERGY ASTHMA & IMMUNOLOGY RESEARCH
- ALLERGY ASTHMA & IMMUNOLOGY RESEARCH vol. 12, no. 5, pp. 750 - 770
- Urticaria; antihistamine, treatment; guideline; evidence; leukotriene; IgE; cyclosporine
- KOREAN ACAD ASTHMA ALLERGY &
- SCIE; SCOPUS; KCI
- Document Type
- Quite a few patients with chronic spontaneous urticaria (CSU) are refractory to H-1-antihistamines, even though the dose of H-1-antihistamines is increased up to 4-fold. CSU that is not controlled with H-1-antihistamines results in increased disease burden. Several immunomodulators have been used to manage these patients. The guidelines reported herein are connected to Part 1 of the KAAACI/KDA Evidence-Based Practice Guidelines for Chronic Spontaneous Urticaria in Korean Adults and Children, and aimed to provide evidence-based recommendations for the management of H-1-antihistamine-refractory CSU. Part 2 focuses on the more commonly used additional treatment options for refractory CSU, including omalizumab, cyclosporine, leukotriene receptor antagonist, dapsone, methotrexate, and phototherapy. The evidence to support their efficacy, dosing, safety, and selection of these agents is systematically reviewed. To date, for patients with refractory CSU, the methodologically sound data to evaluate the use of omalizumab has been growing; however, the evidence of other immunomodulators and phototherapy is still insufficient. Therefore, an individualized stepwise approach with a goal of achieving complete symptom control and minimizing side effects can be recommended. Larger controlled studies are needed to elevate the level of evidence to select a rational therapeutic agent for patients with refractory CSU.
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