With emerging therapies, what is your general treatment ladder for chronic spontaneous urticaria (CSU)?

Antihistamines remain the first-line therapy for CSU, and doses should be optimized before turning to other therapies. If patients fail a trial of adequately-dosed 1st and 2nd gen antihistamines, montelukast is a reasonable adjunct. For patients with high IgE, omalizumab is an excellent choice. For ...