Do Toan T, Canty Ethan A, Joshi Shyam R
From the Department of Internal Medicine, Oregon Health and Science University, Portland, Oregon.
Department of Pediatrics, Oregon Health and Science University, Portland, Oregon, and.
Allergy Asthma Proc. 2023 Jan 1;44(1):3-14. doi: 10.2500/aap.2023.44.220093.
Chronic urticaria (CU), characterized by ≥6 weeks of intense pruritus, remains a debilitating condition for patients. New and safe treatments are needed to manage CU recalcitrant to standard therapy. A review of the current literature of standard and novel therapeutics in the management of CU was conducted. A literature search via a medical literature data base and clinical trial data base was conducted to identify treatment options for CU and current clinical trials. Second-generation antihistamines, omalizumab, and cyclosporine remain the most proven therapeutic options for CU. Dupilumab, mepolizumab, benralizumab, tezepelumab, and CDX-0159 are all undergoing clinical trials for CU. Although ligelizumab demonstrated initial promising results, a phase III study was discontinued due to a nonsuperior clinical impact compared with omalizumab. Novel therapies are needed for the treatment of recalcitrant CU. With a deeper understanding of the pathophysiology of CU, promising therapeutics are in clinical trials for CU.
慢性荨麻疹(CU)的特征是剧烈瘙痒持续≥6周,对患者来说仍是一种使人衰弱的病症。需要新的安全治疗方法来管理对标准治疗无效的CU。对当前关于CU管理的标准和新型疗法的文献进行了综述。通过医学文献数据库和临床试验数据库进行文献检索,以确定CU的治疗选择和当前的临床试验。第二代抗组胺药、奥马珠单抗和环孢素仍然是治疗CU最经证实的治疗选择。度普利尤单抗、美泊利单抗、贝那利珠单抗、tezepelumab和CDX-0159都正在进行针对CU的临床试验。尽管利吉珠单抗最初显示出有希望的结果,但由于与奥马珠单抗相比临床效果无优势,一项III期研究已停止。治疗难治性CU需要新的疗法。随着对CU病理生理学的更深入了解,有前景的治疗方法正在进行针对CU的临床试验。