Chronic spontaneous urticaria (CSU)
- Start daily 2nd-gen H1 antihistamine
- If uncontrolled → increase antihistamine dose
- Persistent CSU → omalizumab
- Remibrutinib is now an oral approved option
- Dupilumab is another biologic option
- Avoid chronic systemic glucocorticoids
- Search for triggers only when history suggests
Use at a glance
- Start daily 2nd-gen H1 antihistamine
Practical pearls
- Persistent CSU → omalizumab
- Remibrutinib is now an oral approved option
- Dupilumab is another biologic option
Choosing treatment
- If uncontrolled → increase antihistamine dose
- Search for triggers only when history suggests
Safety / pitfalls
- Avoid chronic systemic glucocorticoids
Self-check
- What starts CSU treatment?
Daily 2nd-gen H1 antihistamine. - Which drugs are avoided chronically in CSU?
Chronic systemic glucocorticoids.
Drugs used for this (3)
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