Ep. 78: Chronic Spontaneous Urticaria Treatments
Yes, there are more options than antihistamines to treat chronic spontaneous urticaria. We dive into them!
Dr. Sheila Gogate joins us to discuss the chronic spontaneous urticaria (CSU) treatments currently available for patients. Dr. Shaila Gogate outlines the treatment journey for CSU with an emphasis on shared decision-making.
This episode emphasizes the importance of following treatment guidelines and adjusting medications as needed. We discuss the available treatments for urticaria, including antihistamines, omalizumab (Xolair for hives), and Cyclosporine. The episode also explores the journey of managing CSU symptoms through both medical and non-medical approaches.
What we cover in our episode about chronic spontaneous urticaria treatments:
Treatment Path and Guidelines: Overview of doctors' steps to treat CSU. The importance of shared decision-making in the treatment plan.
Antihistamines: Role of oral antihistamines and H2 blockers in managing hives, dosing options, side effects, when to change medications, and how to choose the right antihistamine.
Advanced Treatments: If antihistamines fail, the following steps include omalizumab (Xolair) injections or Cyclosporine. An overview of both dosing options and side effects.
Emerging Therapies: Treatments like Remibrutinib and Dupilumab.
Quality of Life and Non-Medical Management: The Urticaria Activity Score (UAS7). Mental health screening for CSU patients and strategies like stress reduction and if special diets are effective.
About our guest, Dr. Shaila Gogate
Dr. Shaila Gogate, board-certified by the American Board of Allergy & Immunology, has been with Colorado Allergy & Asthma Centers since 2014. She completed her medical education at Chicago Medical School, her residency at Washington University, and her fellowship at National Jewish Health in Denver. Dr. Gogate has served as an Assistant Professor at the University of Colorado, has extensive clinical research experience, and emphasizes strong patient-provider communication to develop effective treatment plans.
More resources about spontaneous hives:
Chronic Urticaria Management, Resources & Glossary of Terms: https://allergyasthmanetwork.org/health-a-z/chronic-urticaria/management-and-resources/
What is Chronic Urticaria: https://allergyasthmanetwork.org/health-a-z/chronic-urticaria/
How Mast Cells Work Video_ mast cell video - explanation of mast cell (07:20): https://youtu.be/OF7tBIvMK_0?si=osJaIpTrivUP1Owr
Urticaria Activity Score (uas7): https://www.mdcalc.com/calc/10226/urticaria-activity-score-uas
More information about XOlair: https://www.xolair.com/chronic-spontaneous-urticaria.html
Other episodes about urticaria:
Treating Chronic Spontaneous Urticaria Episode in a Nutshell
Understanding Antihistamines: Antihistamines are often the first line of treatment for CSU, helping to manage symptoms effectively. Dosing is generally higher than what is on the package.
UAS (Urticaria Activity Score): The UAS7 tool is used to track the severity and frequency of hives, helping doctors adjust treatment plans.
Omalizumab (Xolair): Omalizumab is an advanced treatment option administered through injections. It can be dosed at home or in-office, and potential side effects include injection site reactions and anaphylaxis.
Cyclosporine Therapy: Cyclosporine is another treatment option for CSU, particularly when antihistamines and Omalizumab are not effective or patients want an oral option rather than injection.
Quality of Life: Managing CSU isn't just about medications. Mental health screenings and addressing stress and diet are crucial for improving patients' overall well-being.
We thank Novartis for sponsoring this podcast.
Timestamps
Chronic Spontaneous Urticaria Treatments
01:09 Treatment Path: Overview of how doctors approach CSU treatment.
02:26 Antihistamines: The role of oral therapy in managing CSU.
04:59 Treatment Guidelines: When to change medications according to urticaria guidelines.
06:59 Antihistamines: Why they are used to treat CSU.
08:49 Choosing Antihistamines: Deciding which antihistamine to use.
10:47 Side Effects: Common side effects of antihistamines.
13:29 Alternative Treatments: Next steps if antihistamines are not effective.
16:09 Omalizumab (Xolair) Injections: How this treatment works.
17:59 Urticaria Activity Score: Using UAS7 to track CSU severity.
18:49 Omalizumab Treatment: Home versus in-office dosing.
21:24 Omalizumab Side Effects: Possible side effects to watch for.
23:19 Duration of Treatment: How long do patients need to stay on medications for CSU.
25:19 Cyclosporine Therapy: Oral therapy option.
26:19 New Therapies: Upcoming treatments like Remibrutinib and Dupilumab.
27:39 Quality of Life: Mental health screening for CSU patients.
29:04 Non-Medical Management: Managing hives through stress reduction and special diets.
