Which pharmacologic therapies can be a used to treat severe urticaria (hives)?

Updated: Mar 21, 2018
  • Author: Henry K Wong, MD, PhD; Chief Editor: Michael A Kaliner, MD  more...
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Answer

Cyclosporine has been shown to be effective in 2 double-blind placebo-controlled studies. [56, 57] IV gammaglobulin and plasmapheresis have been described as useful in a limited number of case studies. [58, 59] These therapies can be a consideration in severe urticaria, particularly of the autoimmune type that is unresponsive to medications, but such treatment is usually only initiated by specialists with considerable expertise in urticaria.

Colchicine and dapsone have also been reported to be useful for refractory urticaria and urticarial vasculitis, [60, 61] perhaps because of their ability to modulate polymorphonuclear lymphocyte (PMN) function. PMNs and a mixed infiltrate can be present in some urticarial lesions, particularly urticaria that is severe or refractory to antihistamine treatment.


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