O.Yu.Olisova (1), N.G. Kochergin (1), P.V. Kolkhir (2)

(1) Department of Skin and Venereal Diseases SBEI HPE "First MSMU n.a. I.M. Sechenov" of RMPH, Moscow; (2) Scientific Research Division of Immune-Medicated Dermatoses SBEI HPE "First MSMU n.a. I.M. Sechenov" of RMPH, Moscow
Chronic spontaneous urticaria (CSC) - a skin disease which is mediated by mast cell degranulation and characterized by the appearance of blisters, itching and angioedema during more than 6 weeks without any specific reasons. Purpose of review: discussion of modern international consensus documents on treatment of CSC, as well as the advantages and disadvantages of use of omalizumab - a new biological agent for the treatment of this disease.


  1. Zuberbier T., Aberer W., Asero R., et al. The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update. Allergy. 2014;69(7):868–87.
  2. Bernstein J.A., Lang D.M., Khan D.A., Craig T., Dreyfus D., Hsieh F., Sheikh J., Weldon D., Zuraw B., Bernstein D.I., Blessing-Moore J., Cox L., Nicklas R.A., Oppenheimer J., Portnoy J.M., Randolph C.R., Schuller D.E., Spector S.L., Tilles S.A., Wallace D. The diagnosis and management of acute and chronic urticaria: 2014 update. J. Allergy Clin. Immunol. 2014;133(5):1270–77.
  3. Kozel M.M., Sabroe R.A. Chronic urticaria: aetiology, management and current and future treatment options. Drugs. 2004;64(22):2515–36.
  4. Mullol J., Bousquet J., Bachert C., Canonica G.W., Gimеnez-Arnau A., Kowalski M.L., Simons F.E., Maurer M., Ryan D., Scadding G. Update on rupatadine in the management of allergic disorders. Allergy. 2015(70 Suppl. 100):1–24.
  5. Leurs R., Church M.K., Taglialatela M. H1-antihistamines: inverse agonism, anti-inflammatory actions and cardiac effects. Clin. Exp. Allergy. 2002;32(4):489–98.
  6. Breneman D.L. Cetirizine versus hydroxyzine and placebo in chronic idiopathic urticaria. Ann Pharmacother. 1996;30(10):1075–79.
  7. Finn A.F. Jr., Kaplan A.P., Fretwell R., Qu R., Long J. A double-blind, placebo-controlled trial of fexofenadine HCl in the treatment of chronic idiopathic urticaria. J. Allergy Clin. Immunol. 1999;104(5):1071–78.
  8. Zuberbier T., Münzberger C., Haustein U., Trippas E., Burtin B., Mariz S.D., Henz B.M. Double-blind crossover study of high-dose cetirizine in cholinergic urticaria. Dermatology. 1996:193(4):324–27.
  9. Staevska M., Popov T.A., Kralimarkova T., Lazarova C., Kraeva S., Popova D., Church D.S., Dimitrov V., Church M.K. The effectiveness of levocetirizine and desloratadine in up to 4 times conventional doses in difficult-to-treat urticaria. J. Allergy Clin. Immunol. 2010;125(3):676–82.
  10. Humphreys F., Hunter J.A. The characteristics of urticaria in 390 patients. Br. J. Dermatol. 1998;138(4):635–38.
  11. Zuberbier T. Pharmacological rationale for the treatment of chronic urticaria with second-generation non-sedating antihistamines at higher-than-standard doses. J. Eur. Acad. Dermatol. Venereol. 2012;26(1):9–18.
  12. Kavosh E.R., Khan D.A. Second-generation H1-antihistamines in chronic urticaria: an evidence-based review. Am. J. Clin. Dermatol. 2011;12(6):361–76.
  13. Kessel A., Toubi E. Low-dose cyclosporine is a good option for severe chronic urticaria. J. Allergy Clin. Immunol. 2009;123(4):970; author reply 970–71.
  14. Nettis, E., Colanardi M.C., Paradiso M.T., Ferrannini A. Desloratadine in combination with montelukast in the treatment of chronic urticaria: a randomized, double-blind, placebo-controlled study. Clin. Exp. Allergy. 2004;34(9):1401–407.
  15. Bagenstose S.E., Levin L., Bernstein J.A. The addition of zafirlukast to cetirizine improves the treatment of chronic urticaria in patients with positive autologous serum skin test results. J. Allergy Clin. Immunol. 2004;113(1):134–40.
  16. Konstantinou G.N., Asero R., Ferrer M., Knol E.F., Maurer M., Raap U., Schmid-Grendelmeier P., Skov P.S., Grattan C.E. EAACI taskforce position paper: evidence for autoimmune urticaria and proposal for defining diagnostic criteria. Allergy. 2013;68(1):27–36.
  17. Sperr W.R., Agis H., Czerwenka K., Virgolini I., Bankl H.C., Müller M.R., Zsebo K., Lechner K., Valent P. Effects of cyclosporin A and FK-506 on stem cell factor-induced histamine secretion and growth of human mast cells. J. Allergy Clin. Immunol. 1996;98(2):389–99.
  18. de Paulis A., Stellato C., Cirillo R., Ciccarelli A., Oriente A., Marone G. Anti-inflammatory effect of FK-506 on human skin mast cells. J. Invest Dermatol. 1992;99(6):723–28.
  19. Casolaro V., Spadaro G., Patella V., Marone G. In vivo characterization of the anti22inflammatory effect of cyclosporin A on human basophils. J. Immunol. 1993;151(10):5563–73.
  20. Cirillo, R., Triggiani M., Siri L., Ciccarelli A., Pettit G.R., Condorelli M., Marone G. Cyclosporin A rapidly inhi-bits mediator release from human basophils presumably by interacting with cyclophilin. J. Immunol. 1990;144(10):3891–97.
  21. Marsland A.M., Soundararajan S., Joseph K., Kaplan A.P. Effects of calcineurin inhibitors on an in vitro assay for chronic urticaria. Clin. Exp. Allergy. 2005;35(5):554–59.
  22. Разваляева А.В. Комплексная клиникоэкономическая и фармакоэпидемиоло-гическая оценка противоаллергических препаратов – путь оптимизации лечения и профилактики аллергодерматозов. Дисс. докт. мед. наук. Волгоград, 2010.
  23. Grattan C.E., O’Donnell B.F., Francis D.M., Niimi N., Barlow R.J., Seed P.T., Kobza Black A., Greaves M.W. Randomized double-blind study of cyclosporin in chronic ‘idiopathic’ urticaria. Br. J. Dermatol. 2000;143(2):365–72.
  24. Vena G.A., Cassano N., Colombo D., Peruzzi E., Pigatto P. Cyclosporine in chronic idiopathic urticaria: a double-blind, randomized, placebo-controlled trial. J. Am. Acad. Dermatol. 2006;55(4):705–9.
  25. Hollander S.M., Joo S.S., Wedner H.J. Factors that predict the success of cyclosporine treatment for chronic urticaria. Ann. Allergy Asthma Immunol. 2011;107(6):523–28.
  26. Bleehen S.S., Thomas S.E., Greaves M.W., Newton J., Kennedy C.T., Hindley F., Marks R., Hazell M., Rowell N.R., Fairiss G.M., et al. Cimetidine and chlorpheniramine in the treatment of chro-nic idiopathic urticaria: a multi-centre randomized double-blind study. Br. J. Dermatol. 1987;117(1):81–8.
  27. Greene S.L., Reed C.E., Schroeter A.L. Double-blind crossover study comparing doxepin with diphenhyd-ramine for the treatment of chronic urticaria. J. Am. Acad. Dermatol. 1985;12(4):669–75.
  28. Harto A., Sendagorta E., Ledo A. Doxepin in the treatment of chronic urticaria. Dermatologica. 1985;170(2):90–3.
  29. Deschildre A., Marguet C., Langlois C., Pin I., Rittiе J.L., Derelle J., Abou Taam R., Fayon M., Brouard J., Dubus J.C., Siret D., Weiss L., Pouessel G., Beghin L., Just J. Real-life long-term omalizumab therapy in children with severe allergic asthma. Eur. Respir. J. 2015.
  30. Holgate S., Casale T., Wenzel S., Bousquet J., Deniz Y., Reisner C. The anti-inflammatory effects of omalizumab confirm the central role of IgE in allergic inflammation. J. Allergy Clin. Immunol. 2005;115(3):459–65.
  31. Casale T.B., Bernstein J.A., Maurer M., Saini S.S., Trzaskoma B., Chen H., Grattan C.E., Gimenеz-Arnau A., Kaplan A.P., Rosеn K. Similar Efficacy with Omalizumab in Chronic Idiopathic/Spontaneous Urticaria Despite Different Background Therapy. J. Allergy Clin. Immunol. Pract. 2015.
  32. Tontini C., Marinangeli L., Cognigni M., Bilо M.B., Antonicelli L. Omalizumab in chronic spontaneous urticaria: patient-tailored tapering or planned discontinuation? Ann. Allergy Asthma Immunol. 2015.
  33. Netchiporouk E., Nguyen C.H., Thuraisingham T., Jafarian F., Maurer M., Ben-Shoshan M. Management of pediatric chronic spontaneous and physical urticaria patients with omalizumab: case series. Pediatr. Allergy Immunol. 2015.
  34. Spector S.L. Tan R.A. Omalizumab also successful in chronic urticaria. J. Allergy Clin. Immunol. 2008;121(3):784; author reply 784–85.
  35. Saini S., Rosen K.E., Hsieh H.J., Wong D.A., Conner E., Kaplan A., Spector S., Maurer M. A randomized, placebo-controlled, dose-ranging study of single-dose omalizumab in patients with H1-antihistamine-refractory chronic idiopathic urticaria. J. Allergy Clin. Immunol. 2011;128(3):567–73 e1.
  36. Maurer M., Altrichter S., Bieber T., Biedermann T., Brаutigam M., Seyfried S., Brehler R., Grabbe J., Hunzelmann N., Jakob T., Jung A., Kleine-Tebbe J., Mempel M., Meurer M., Reich K., Ruеff F., Schаkel K., Sengupta K., Sieder C., Simon J.C., Wedi B., Zuberbier T., Mahler V., Staubach P. Efficacy and safety of omalizumab in patients with chronic urticaria who exhibit IgE against thyroperoxidase. J. Allergy Clin. Immunol. 2011;128(1):202–9 e5.
  37. Cox L., Platts-Mills T.A., Finegold I., Schwartz L.B., Simons F.E., Wallace D.V. American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma and Immunology Joint Task Force Report on omalizumab-associated anaphylaxis. J. Allergy Clin. Immunol. 2007;120(6):1373–77.
  38. Urgert M.C., van den Elzen M.T., Knulst A.C., Fedorowicz Z., van Zuuren E.J. Omalizumab in patients with chronic spontaneous urticaria: a systematic review and GRADE assessment. Br. J. Dermatol. 2015.

About the Autors

O.Yu. Olisova – Doctor of Medical Sciences, Prof., Head of the Department of Skin and Venereal Diseases SBEI HPE "First MSMU n.a. I.M. Sechenov" of RMPH, Moscow

Similar Articles

Бионика Медиа