Guidelines of the Czech Society of Dermatology ČLS JEP and the Czech Society of Allergology and Clinical Immunology for the Treatment of Chronic Spontaneous Urticaria
Abstract
Chronic spontaneous urticaria is relatively common disease with considerable impact on patient's quality of life, impairing the performance at school, work and in daily life. Early diagnostics and early appropriate treatment are crucial for getting the disease and it's symptoms under control. The update and revision of international guidelines for the treatment of chronic urticaria (2021) as a joint initiative of The European Academy of Allergy and Clinical Immunology (EAACI), Global Allergy and Asthma European Network (GA2LEN), European Dermatology Forum (EDF) and The Asia Pacific Association of Allergy, Asthma and Clinical Immunology (APAAACI) represent a suitable tool for clinical practice in the Czech Republic. Proven non-sedative 2nd generation antihistamines are the first line of therapy, even in increased dosage. These can be administered even by general practitioners as they are often the first physicians seen by the patient. Omalizumab is added to the antihistamine as a second line, and now also at higher doses. In the third line, cyclosporin A is in combination with an antihistamine. This treatment is in the competence of specialists in specialized centers.
Due to the interdisciplinary character of chronic urticaria, it is effective and beneficial to manage the treatment of patients with chronic urticaria not only by dermatologists, but also by allergologists and clinical immunologist, including higher-line treatments such as biologics and immunosuppressants and kinase inhibitors and other drugs in the future. The article was revised by the Expert Working Group of both professional societies and approved by the committees of The Czech Dermatovenerological Society and The Czech Society for Allergology and Clinical Immunology.