Joseph Diaz, MD- Advances in Chronic Spontaneous Urticaria: Expert Insight on Translating Progress to Practice for Improved Symptom Control and Quality of Life

Go online to PeerView.com/HWY860 to view the activity, download
slides and practice aids, and complete the post-test to earn
credit. Chronic spontaneous urticaria (CSU) is defined by the
presence of recurrent urticaria, angioedema, or both, for a period
of 6 weeks or longer. There are several theories regarding the
pathogenesis of CSU, none of which have been conclusively
established. CSU is a self-limited disorder in most patients, with
an average duration of disease of 2 to 5 years; although active CSU
significantly impairs quality of life. Second-generation H1
antihistamines (sgAHs) in standard dose are effective in less than
50% of CSU patients. Increasing the dose of sgAHs improves
treatment responses; however, every third to fourth patient will
still remain symptomatic. Omalizumab, an anti-IgE monoclonal
antibody, may also be used for effective treatment, as well as
cyclosporine. The current guideline-recommended treatment
algorithm, though useful, is not perfect. The treatment of patients
with CSU should be individualized and take into account the
likelihood of patients to respond to therapy, based on predictors
of response. By choosing treatment options tailored to a patient’s
clinical or biochemical characteristics, treatments that are less
likely to be effective may be avoided. In this activity, based on a
live symposium held at the AAD Annual Meeting in Boston, a panel of
experts will discuss the selection of adequate and relevant tests
for the diagnostic workup in CSU and novel treatment options for
CSU in the context of mechanism of action, efficacy, and safety. In
addition, they will take a closer look at treating CSU in
accordance with current evidence and expert recommendations,
recognizing that as the era of personalized treatment emerges, the
best use for newer agents will be achieved with a deeper
understanding of both the phenotype and endotype of each CSU
patient. Upon completion of this activity, participants should be
better able to: Select adequate and relevant tests for the
diagnostic workup in chronic spontaneous urticaria (CSU) by
obtaining a thorough medical history, Discuss how recent insights
into the pathogenesis of CSU have led to the development of novel
therapeutic targets, Describe novel treatment options for CSU in
the context of mechanism of action, efficacy, and safety, Treat CSU
in accordance with current evidence and expert recommendations,
recognizing that as the era of personalized treatment emerges, the
best use for newer agents will be achieved with a deeper
understanding of both the phenotype and endotype of each CSU
patient.