How do you select your first line therapy in patients with CSU?

Does your approach vary significantly based on severity of presentation?

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How long of a trial of 4x standard dose anti-histamine do you give for severe CSU before considering it a failure and escalating to systemic biologic therapy?

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2 Answers

Mednet Member

Dermatology · Herbert Wertheim College of Medicine at Florida International University

Answered on

My basic first-line strategy does not change with severity; what changes is the speed with which I optimize and escalate therapy.

For example, with a patient in whom I am confident the diagnosis is CSU, I begin with a second-generation H1 antihistamine at the standard approved dose, taken regularly-...

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Mednet Member

Dermatology · University of Saskatchewan

Answered on

First, I would want to confirm the diagnosis and phenotype: Urticaria only, angioedema, or both, recurring for at least six weeks without a consistent inducible trigger. My first-line treatment is one modern second-generation H1 antihistamine with low sedating potential taken regularly at the licens...

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