Chronic spontaneous urticaria (CSU) is defined as the presence of recurrent
urticaria for more than 6 weeks. The exact etiology of CSU has not been elucidated.
Multiple studies have shown that the screening with multitude of laboratory tests
infrequently identifies a disease causing abnormality and rarely changes clinical
management or outcomes. Management of patient with CSU may be challenging, as
many require more than two anti-allergy medications that require close monitoring.
Current published guidelines recommend a step-wise approach for the treatment of
CSU, newer drugs such as omalizumab, a monoclonal anti-IgE antibody; have been
successfully used to treat refractory disease. In this chapter, we will review the
common therapeutic agents used in the management of CSU, their side effects,
monitoring parameters and the level of evidence as described in the current literature.
Keywords: Antihistamines, Cetirizine, Chronic spontaneous urticarial, Chronic
urticarial, Cyclosporine, Desloratadine, Doxepin, Fexofenandine, Hydroxyzine,
Omalizumab.
