Treatment of Chronic Urticaria

Second-generation antihistamines are unquestionably the first-line treatment for chronic urticaria and can be used at higher than licensed doses if normal doses fail to control the disease. A short course of oral corticosteroids should be considered for patients not responding to antihistamines before trying other immunosuppressive drugs. Ciclosporin is effective in most antihistamine-resistant patients who require long-term corticosteroid treatments to control their disease. Omalizumab is effective in most subsets of chronic urticaria sufferers who do not respond to other treatments but its high cost represents a limitation to its widespread use.