Please login or create an account. If you do not have access to this content, you will be shown a 30 second preview and licensing options.
- Presentation
Urticaria Review & Update
Description
This presentation offers a comprehensive update on urticaria, emphasizing its complexity and the need for careful clinical diagnosis. The speaker underlines the distinction between acute and chronic urticaria, highlighting that most patients experience chronic conditions, particularly women. With a focus on the science behind urticaria, the discussion includes definitions, typical presentations, and the critical role of mast cells in the disease's pathogenesis. The speaker introduces modern therapies, notably omalizumab (Xolair), an anti-IgE treatment effective for many patients, and discusses dupilumab, offering promising results in reducing symptoms related to type 2 inflammation. Additionally, emerging treatments like remibrutinib, a Bruton tyrosine kinase inhibitor, are presented as innovative oral options that may address urticaria's underlying mechanisms. The importance of recognizing urticaria as a dermatological condition, rather than solely an allergy issue, is framed as a call to action for dermatologists to take an active role in patient management. The presentation aims to enhance understanding and treatment of urticaria by highlighting the latest research and therapeutic advancements.
View moreConclusions
- Urticaria is a heterogeneous disease, with a predominance of chronic cases rather than acute ones.
- Chronic urticaria can last several years, and many patients do not achieve remission over long periods.
- Mast cells are central to the pathogenesis of urticaria and their activation leads to the condition's characteristic symptoms.
- Chronic spontaneous urticaria (CSU) often lacks clear identifiable triggers and is best classified as an autoimmune disease.
- Women are more commonly affected by urticaria, potentially due to a higher propensity for autoimmune conditions.
- Treatment options for urticaria include antihistamines, monoclonal antibodies like omalizumab, and newer therapies targeting different pathways.
- Omalizumab shows a high complete response rate in treating CSU, making it a standard treatment option for patients.
- Dupilumab has demonstrated effectiveness in reducing symptoms in CSU but its efficacy in patients previously treated with omalizumab is less clear.
- Emerging therapies like remibrutinib, a BTK inhibitor, show promise in impacting mast cell activation and CSU symptoms.
- Dermatologists should take a leading role in managing patients with urticaria rather than referring them to allergists.
- Kozel, 2001
- Beltrani, 2002
- Van Der Valk, 2002
- Kulthanan, 2007
- Boonpiyathad, 2016
- Chuamanochan, 2016
- Kim, 2018
- Varricchi et al. (2017) Front. Immunol.
- Maurer et al. (2020) Int Arch Allergy Immunol.
- Ghazanfar MN et al. (2020) World Allergy Organ J.
- Altrichter et al. (2021) Allergy Asthma Immunol Res.
- Giustizieri et al. (2004) JACI.
- Tharp, M. D. et al. (2019) JAMA Derm.
- Maurer M et al. (2022) JACI.