What are the EAACI/GA2LEN/EDF/WAO treatment guidelines for chronic urticaria?

Updated: Jul 31, 2018
  • Author: Marla N Diakow, MD; Chief Editor: William D James, MD  more...
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Answer

A brief summary and highlights of EAACI/GA2LEN/EDF/WAO guidelines are as follows:

  • First-line treatment is second-generation H 1 antihistamines
  • Second-line therapy is up-dosing second-generation H 1 antihistamines
  • Third-line treatment is omalizumab, which is recommended before the more toxic cyclosporine A
  • H 2 antihistamines not included in algorithm (used only on an individual case basis but not as first-, second-, or third-line treatment)
  • Avoid first-generation H 1 antihistamines based on benefit-to-risk ratio
  • Corticosteroids considered only for the short-term intervention; avoid as long-term treatment
  • Acknowledged role for cyclosporine A as add-on for refractory chronic urticaria not responsive to other treatments

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