Zuberbier Torsten, Maurer Marcus
Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, D-10117, Berlin, Germany.
Expert Rev Clin Immunol. 2015 Feb;11(2):171-80. doi: 10.1586/1744666X.2015.993971. Epub 2015 Jan 7.
Urticaria is a common and often debilitating dermatological condition defined by the sudden appearance of wheals, angioedema or both. It is further classified into specific subtypes based on duration and specific triggers. Awareness and understanding of urticaria are important to ensure a correct initial diagnosis and initiate appropriate guideline-based treatment outlining a stepwise approach. However, in chronic urticaria, approximately 50% of patients are refractory to the first step, the use of licensed doses of second-generation H1-antihistamines. If the second step, an increase in the dose of the second-generation H1-antihistamines, is also not successful, in the third step omalizumab (Xolair™, Novartis Pharma AG(©)/Genentech, Inc.(©)), an anti-IgE therapy, is recommended as an add-on. Of all alternative treatments mentioned in the guidelines, omalizumab is currently the only licensed treatment for H1-antihistamine-refractory chronic spontaneous urticaria, has a favorable risk/benefit ratio and was well tolerated in clinical studies.
荨麻疹是一种常见且常使人衰弱的皮肤病，其特征为突然出现风团、血管性水肿或两者皆有。根据病程和特定诱因，它可进一步分为特定亚型。认识和了解荨麻疹对于确保正确的初始诊断以及启动基于指南的适当治疗（概述一种逐步治疗方法）非常重要。然而，在慢性荨麻疹患者中，约50%的患者对第一步治疗（使用许可剂量的第二代H1抗组胺药）无效。如果第二步治疗（增加第二代H1抗组胺药的剂量）也不成功，那么在第三步中，建议添加奥马珠单抗（Xolair™，诺华制药有限公司(©)/基因泰克公司(©)）进行治疗，这是一种抗IgE疗法。在指南中提及的所有替代治疗方法中，奥马珠单抗是目前唯一被许可用于治疗对H1抗组胺药难治的慢性自发性荨麻疹的药物，具有良好的风险/效益比，并且在临床研究中耐受性良好。
