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Omalizumab for previously treated chronic spontaneous urticaria

Omalizumab for previously treated chronic spontaneous urticaria
Omalizumab for previously treated chronic spontaneous urticaria
Urticaria (also known as hives, welts or nettle rash) is a vascular reactioncharacterised by the transient appearance of raised, itchy lesions ('wheals')on the skin. It occurs when histamine and other chemicals are released from under the surface of the skin, causing tissues to swell. The lifetime prevalence of chronic urticaria in the UK is 0.5 1%, but approximately 15% of people experience urticaria at some time in their lives. For many people with urticaria, the cause of their condition is unknown. Individual wheals can change size rapidly and move around the skin, disappearing in one place and then reappearing somewhere else on the body. They generally appear on the skin for no longer than 24 hours; however, the condition may persist for several months. Angioedema (swelling of lips, hands and feet) may also be present. When symptoms are present for more than 6 weeks, the condition is considered to be chronic. Symptoms may persist for 3 5 years in approximately 50% of people, and for more than 10 years in 20% of people. Initial treatment of chronic spontaneous urticaria is a non-sedating H1- antihistamine (for example, cetirizine, levocetirizine, fexofenadine, loratadine, bilastine, desloratadine). Dose escalation of the antihistamine (2-fold and then 4-fold) may be required if the standard dose is ineffective. Subsequent treatment options for people whose condition does not respond to non- sedating antihistamines include leukotriene receptor antagonists, H2-receptor antagonists, immunosuppressant drugs (such as ciclosporin, mycophenolate mofetil and methotrexate) and tetrahydrofolate dehydrogenase inhibitors (such as dapsone). Oral corticosteroid pulses may be used to treat exacerbations.
Urticaria, hives, omalizumab, antihistamine, chronic spontaneous urticaria, clinical effectiveness, cost effectiveness
NIHR Journals Library
Jones, Jeremy
270b303b-6bad-4be7-8ea0-63d0e8015c91
Cooper, Keith
ea064f58-d71d-404a-bcf3-49d243b8825b
Picot, Joanna
324d6f20-a105-49fd-9fb0-88791be84ada
Harris, Petra
a8bd143b-3e2c-4929-9279-510a4c60bd09
Loveman, Emma
06ff1bf1-0189-4330-b22d-f5a917e9871d
Jones, Jeremy
270b303b-6bad-4be7-8ea0-63d0e8015c91
Cooper, Keith
ea064f58-d71d-404a-bcf3-49d243b8825b
Picot, Joanna
324d6f20-a105-49fd-9fb0-88791be84ada
Harris, Petra
a8bd143b-3e2c-4929-9279-510a4c60bd09
Loveman, Emma
06ff1bf1-0189-4330-b22d-f5a917e9871d

Jones, Jeremy, Cooper, Keith, Picot, Joanna, Harris, Petra and Loveman, Emma (2014) Omalizumab for previously treated chronic spontaneous urticaria NIHR Journals Library 108pp.

Record type: Monograph (Project Report)

Abstract

Urticaria (also known as hives, welts or nettle rash) is a vascular reactioncharacterised by the transient appearance of raised, itchy lesions ('wheals')on the skin. It occurs when histamine and other chemicals are released from under the surface of the skin, causing tissues to swell. The lifetime prevalence of chronic urticaria in the UK is 0.5 1%, but approximately 15% of people experience urticaria at some time in their lives. For many people with urticaria, the cause of their condition is unknown. Individual wheals can change size rapidly and move around the skin, disappearing in one place and then reappearing somewhere else on the body. They generally appear on the skin for no longer than 24 hours; however, the condition may persist for several months. Angioedema (swelling of lips, hands and feet) may also be present. When symptoms are present for more than 6 weeks, the condition is considered to be chronic. Symptoms may persist for 3 5 years in approximately 50% of people, and for more than 10 years in 20% of people. Initial treatment of chronic spontaneous urticaria is a non-sedating H1- antihistamine (for example, cetirizine, levocetirizine, fexofenadine, loratadine, bilastine, desloratadine). Dose escalation of the antihistamine (2-fold and then 4-fold) may be required if the standard dose is ineffective. Subsequent treatment options for people whose condition does not respond to non- sedating antihistamines include leukotriene receptor antagonists, H2-receptor antagonists, immunosuppressant drugs (such as ciclosporin, mycophenolate mofetil and methotrexate) and tetrahydrofolate dehydrogenase inhibitors (such as dapsone). Oral corticosteroid pulses may be used to treat exacerbations.

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More information

Published date: 25 November 2014
Keywords: Urticaria, hives, omalizumab, antihistamine, chronic spontaneous urticaria, clinical effectiveness, cost effectiveness

Identifiers

Local EPrints ID: 412794
URI: http://eprints.soton.ac.uk/id/eprint/412794
PURE UUID: 3983e005-66aa-48b2-985b-46e8ec3c1145
ORCID for Joanna Picot: ORCID iD orcid.org/0000-0001-5987-996X
ORCID for Petra Harris: ORCID iD orcid.org/0000-0001-9257-3786

Catalogue record

Date deposited: 01 Aug 2017 16:31
Last modified: 14 Mar 2019 01:43

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