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SATURDAYOctober 19SESSION 210:05 – 10:25 |
Eugene Monroe The ideal treatment for urticaria is identification and elimination or reduction of its cause. The etiology of acute urticaria is usually detectable; but most cases of chronic urticaria are idiopathic. Therefore, treatment programs for chronic urticaria rely largely on drug therapy to provide symptomatic relief. In general, the drug therapy of urticaria can be divided into three different approaches. The first is to block the effects of already released histamine on the receptor sites of cutaneous blood vessels. This can be accomplished by using H1 antihistamines, tricyclic antidepressants or the combination of H1 and H2 antihistamines. The second is to block the release of histamine and other mediators from mast cells. The third is to block mediators other than histamine and possible inflammatory and cellular components involved in the urticarial process. H1 antihistamines remain the first choice of therapy for urticaria. Some of the second-generation antihistamines are the treatment of choice for many patients with urticaria because of their comparable efficacy and better safety profile compared to the first-generation antihistamines. Several other agents have demonstrated additive value when monotherapy with H1 antihistamines is not sufficient to control the urticaria. Some of the newer second-generation H1 antihistamines (such as desloratadine) that combine potent H1 receptor antagonism with potential anti-allergic and anti-inflammatory activities may provide further advances in the treatment of urticaria. The purpose of this presentation is to review the advantages and disadvantages of different pharmacologic treatment options for patients with chronic urticaria. Data on recently conducted and or published studies will be presented. An attempt will be made to develop a practical, rational treatment algorithm for urticaria patients. |