First AD

Second AD

Role of Antihistamines, Steroids and Biologics in Treating CSU

Video content above is prompted by the following:

What challenges and limitations are associated with second-generation H1 antihistamines as ﬁrst-line therapy?

Can you describe the increased second-generation antihistamine dosages recommended for patients who do not respond to standard doses?

Please describe the limitations and challenges associated with cycling through antihistamines.

When are combination therapies appropriate for consideration? How and when do you decide to make a change in therapy?

What role do steroids play in the management of CSU?

What cautions should practitioners be aware of regarding use of systemic steroids for CSU?

When is the appropriate time to escalate to advanced therapies, and what are the variables that you consider in that decision?

What are the treatment gaps that exist for antihistamine cycling and biologics?

Peer Exchange: Evolving Perspectives and Treatment Strategies in Chronic Spontaneous Urticaria 

HCPLive® Peer Exchange panel discussions feature authoritative insights, opinions, and perspectives on important issues facing today's care professionals.

Peer Exchange

Second-generation H1 antihistamines, while effective, face challenges such as limited efficacy in some patients and potential side effects at higher doses. Increased dosages are recommended for non-responders, but this approach has limitations, including potential side effects and diminishing returns. Cycling through antihistamines can lead to inconsistent results and patient dissatisfaction. Combination therapies are considered when monotherapy fails, with decisions based on patient response and symptom severity. Systemic steroids play a role in managing chronic spontaneous urticaria (CSU), but caution is advised due to potential side effects. Escalation to advanced therapies depends on treatment response and patient-specific factors.

Panelists discuss the challenges and limitations of using second-generation H1 antihistamines as first-line therapy for chronic spontaneous urticaria (CSU), including recommended increased dosages for nonresponding patients and the complexities of cycling through antihistamines. They also explore the appropriate circumstances for considering combination therapies, the role of steroids in management, necessary precautions when using systemic steroids, and the factors influencing the decision to escalate to advanced therapies, while identifying existing treatment gaps for antihistamine cycling and biologics.