Treatment Goals and Guidelines for CSU

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Key Takeaways

Treatment goals are shaped by disease severity, patient preferences, and clinical guidelines, ensuring personalized care.
Antihistamines are the first-line treatment, with updosing considered for insufficient response by altering dosage or interval.
Omalizumab is the second-line treatment, initiated at 300 mg every four weeks, followed by cyclosporine as the third-line option.
Treatment should be adjusted based on disease control, with step-up and step-down strategies recommended for optimal management.

Panelists discuss the factors influencing the development of treatment goals for chronic spontaneous urticaria (CSU) from both patient and physician perspectives, highlighting current international guidelines that recommend antihistamines as first-line treatment, with options for updosing, and outlining second-line therapies such as omalizumab and third-line options like cyclosporine, along with the recommendation to adjust treatment based on disease control levels.

EP: 1.Overview of CSU: Prevalence and Presentations

EP: 2.Impact of CSU on Patient Quality of Life

EP: 3.Pathophysiology of CSU and Role of BTK

EP: 4.Diagnostic Approach to CSU

EP: 5.Role of Testing in CSU Diagnosis

EP: 6.Referring CSU Patients to a Specialist

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EP: 7.Treatment Goals and Guidelines for CSU

Video content above is prompted by the following:

What are the factors that shape the development of treatment goals, both for patients and physicians?
What do international guidelines currently recommend for therapeutic approach? (Zuberbier, J Allergy Clin Immunol, 2022)
- First-line treatment: antihistamine
- Patients with insufficient response, updosing should be considered, via shortening interview and/or increasing dosage
- Second-line treatment: omalizumab; start with 300 mg/4 weeks
- Third-line treatment: cyclosporine
- General recommendation to step-up and step-down treatment based on levels of disease control