An update on the use of antihistamines in managing chronic urticaria

References

• Zuberbier T, Abdul Latiff AH, Abuzakouk M, et al. The international EAACI/GA(2)LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy. 2022 Mar;77:(3):734–766.
   PubMed Web of Science ®Google Scholar
• Xiang YK, Guloglu S, Elieh-Ali-Komi D, et al. Chronic spontaneous urticaria: new evidences on the role of autoimmunity. Curr Opin Allergy Clin Immunol. 2023 Oct 1;23(5):438–445. doi: 10.1097/ACI.0000000000000927
   PubMed Web of Science ®Google Scholar
• Asero R, Ferrer M, Kocaturk E, et al. Chronic spontaneous urticaria: the role and relevance of Autoreactivity, autoimmunity, and Autoallergy. J Allergy Clin Immunol Pract. 2023 Aug;11:(8):2302–2308.
   PubMed Web of Science ®Google Scholar
• Turk M, Kocaturk E, Ertas R, et al. A global perspective on stepping down chronic spontaneous urticaria treatment: results of the urticaria centers of reference and excellence SDown-CSU study. Clin Transl Allergy. 2024 Feb;14:(2):e12343.
   PubMed Web of Science ®Google Scholar
• Bernstein JA, Lang DM, Khan DA, et al. The diagnosis and management of acute and chronic urticaria: 2014 update. J Allergy Clin Immunol. 2014 May;133:(5):1270–1277.
   PubMed Web of Science ®Google Scholar
• Sabroe RA, Lawlor F, Grattan CEH, et al. British association of dermatologists guidelines for the management of people with chronic urticaria 2021. Br J Dermatol. 2022 Mar;186:(3):398–413.
   PubMed Web of Science ®Google Scholar
• Göncü EK, Aktan Ş, Nn A, et al. The Turkish guideline for the diagnosis and management of urticaria-2016. Turkderm. 2016;50(3):82–98. doi: 10.4274/turkderm.22438
   Google Scholar
• Centre for Urticaria Research CSoD. Guideline for diagnosis and treatment of urticaria in China （2022). Chinese J Dermatol. 2022 Dec 15;55(12):1041–1049.
   Google Scholar
• Ayse Ornek S, Orcen C, Church MK, et al. An evaluation of remission rates with first and second line treatments and indicators of antihistamine refractoriness in chronic urticaria. Int Immunopharmacol. 2022 Nov;112:109198. doi: 10.1016/j.intimp.2022.109198
   PubMed Web of Science ®Google Scholar
• Guillen-Aguinaga S, Jauregui Presa I, Aguinaga-Ontoso E, et al. Updosing nonsedating antihistamines in patients with chronic spontaneous urticaria: a systematic review and meta-analysis. Br J Dermatol. 2016 Dec175:(6):1153–1165.
   PubMed Web of Science ®Google Scholar
• Iriarte Sotes P, Armisen M, Usero-Barcena T, et al. Efficacy and safety of up-dosing antihistamines in chronic spontaneous urticaria: a systematic review of the literature. J Investig Allergol Clin Immunol. 2021 Jul 26;31(4):282–291. doi: 10.18176/jiaci.0649
   PubMed Web of Science ®Google Scholar
• van den Elzen MT, van Os-Medendorp H, van den Brink I, et al. Effectiveness and safety of antihistamines up to fourfold or higher in treatment of chronic spontaneous urticaria. Clin Transl allergy. 2017;7:4. doi: 10.1186/s13601-017-0141-3
   PubMed Web of Science ®Google Scholar
• Ornek S, Kocaturk E. A patient-oriented approach to long-term use of omalizumab in chronic spontaneous urticaria. Cutan Ocul Toxicol. 2021 Dec;40(4):305–311. doi: 10.1080/15569527.2021.1945618
   PubMed Web of Science ®Google Scholar
• Kocaturk E, Deza G, Kiziltac K, et al. Omalizumab updosing for better disease control in chronic spontaneous urticaria patients. Int Arch Allergy Immunol. 2018;177(4):360–364. doi: 10.1159/000491530
   PubMed Web of Science ®Google Scholar
• Can PK, Salman A, Hosgoren-Tekin S, et al. Effectiveness of omalizumab in patients with chronic inducible urticaria: real-life experience from two UCARE centres. J Eur Acad Dermatol Venereol. 2021 Oct;35:(10):e679–e682.
   PubMed Web of Science ®Google Scholar
• Ghazanfar MN, Sand C, Thomsen SF. Effectiveness and safety of omalizumab in chronic spontaneous or inducible urticaria: evaluation of 154 patients. Br J Dermatol. 2016 Aug;175(2):404–406. doi: 10.1111/bjd.14540
   PubMed Web of Science ®Google Scholar
• Kocaturk E, Saini SS, Rubeiz CJ, et al. Existing and investigational medications for refractory chronic spontaneous urticaria: safety, adverse effects, and monitoring. J Allergy Clin Immunol Pract. 2022 Dec;10:(12):3099–3116.
   PubMed Web of Science ®Google Scholar
• Kocaturk E, Baskan EB, Kucuk OS, et al. Omalizumab versus cyclosporin-A for the treatment of chronic spontaneous urticaria: can we define better-responding endotypes? An Bras Dermatol. 2022 Sep;97:(5):592–600.
   PubMed Web of Science ®Google Scholar
• Picone V, Napolitano M, Martora F, et al. Urticaria relapse after mRNA COVID-19 vaccines in patients affected by chronic spontaneous urticaria and treated with antihistamines plus omalizumab: a single-center experience. Dermatol Ther. 2022 Nov;35:(11):e15838.
   PubMed Web of Science ®Google Scholar
• Del Cuvillo A, Mullol J, Bartra J, et al. Comparative pharmacology of the H1 antihistamines. J Investig Allergol Clin Immunol. 2006;16 Suppl 1:3–12.
   PubMedGoogle Scholar
• Waller D, Sampson AP, Hitchings A, et al. Medical pharmacology & therapeutics. Sixth edition. ed. London (NY): Elsevier; 2022. English.
   Google Scholar
• Kenakin TP. Comprehensive pharmacology. Amsterdam Netherlands: Elsevier; 2022. English.
   Google Scholar
• Bolognia J, Schaffer JV, Cerroni L. Dermatology. Fourth edition. ed. Philadelphia (Pa): Elsevier; 2018. English.
   Google Scholar
• Zuberbier T, Grattan C, Maurer M, et al. Urticaria and angioedema. Second edition. ed. Cham Switzerland: Springer Nature Switzerland AG; 2021. English.
   Google Scholar
• Elieh-Ali-Komi D, Metz M, Kolkhir P, et al. Chronic urticaria and the pathogenic role of mast cells. Allergol Int. 2023 Jul;72:(3):359–368.
   PubMed Web of Science ®Google Scholar
• O’Hehir RE, Holgate ST, Hershey GKK, et al. Allergy essentials. Second edition. ed. Philadelphia (PA): Elsevier; 2022. English.
   Google Scholar
• Church MK, Maurer M. Antihistamines. Chem Immunol Allergy. 2014;100:302–310.
   PubMedGoogle Scholar
• Holgate ST, Canonica GW, Simons FE, et al. Consensus Group on new-generation antihistamines (CONGA): present status and recommendations. Clin Exp Allergy. 2003 Sep;33:(9):1305–1324.
   PubMed Web of Science ®Google Scholar
• Li L, Liu R, Peng C, et al. Pharmacogenomics for the efficacy and side effects of antihistamines. Exp Dermatol. 2022 Jul;31:(7):993–1004.
   PubMed Web of Science ®Google Scholar
• Leurs R, Church MK, Taglialatela M. H1-antihistamines: inverse agonism, anti-inflammatory actions and cardiac effects. Clin Exp Allergy. 2002 Apr;32(4):489–498. doi: 10.1046/j.0954-7894.2002.01314.x
   PubMed Web of Science ®Google Scholar
• Cataldi M, Maurer M, Taglialatela M, et al. Cardiac safety of second-generation H(1) -antihistamines when updosed in chronic spontaneous urticaria. Clin Exp Allergy. 2019 Dec;49:(12):1615–1623.
   PubMed Web of Science ®Google Scholar
• Simons FE, Simons KJ. Histamine and H1-antihistamines: celebrating a century of progress. J Allergy Clin Immunol. 2011 Dec;128(6):1139–1150 e4. doi: 10.1016/j.jaci.2011.09.005
   PubMed Web of Science ®Google Scholar
• Ochoa D, Roman M, Belmonte C, et al. Pharmacokinetics and safety of a bilastine once-daily, preservative-free, ophthalmic formulation. Adv Ther. 2021 Jul;38:(7):4070–4081.
   PubMed Web of Science ®Google Scholar
• Shamizadeh S, Brockow K, Ring J. Rupatadine: efficacy and safety of a non-sedating antihistamine with PAF-antagonist effects. Allergo J Int. 2014;23(3):87–95. doi: 10.1007/s40629-014-0011-7
   PubMedGoogle Scholar
• Hide M, Yagami A, Togawa M, et al. Efficacy and safety of bilastine in Japanese patients with chronic spontaneous urticaria: a multicenter, randomized, double-blind, placebo-controlled, parallel-group phase II/III study. Allergol Int. 2017 Apr;66:(2):317–325.
   PubMed Web of Science ®Google Scholar
• Kapp A, Pichler WJ. Levocetirizine is an effective treatment in patients suffering from chronic idiopathic urticaria: a randomized, double-blind, placebo-controlled, parallel, multicenter study. Int J Dermatol. 2006 Apr;45(4):469–474. doi: 10.1111/j.1365-4632.2005.02609.x
   PubMed Web of Science ®Google Scholar
• Nettis E, Colanardi MC, Barra L, et al. Levocetirizine in the treatment of chronic idiopathic urticaria: a randomized, double-blind, placebo-controlled study. Br J Dermatol. 2006 Mar;154:(3):533–538.
   PubMed Web of Science ®Google Scholar
• Hide M, Suzuki T, Tanaka A, et al. Efficacy and safety of rupatadine in Japanese adult and adolescent patients with chronic spontaneous urticaria: a double-blind, randomized, multicenter, placebo-controlled clinical trial. Allergol Int. 2019 Jan;68:(1):59–67.
   PubMed Web of Science ®Google Scholar
• Gimenez-Arnau A, Pujol RM, Ianosi S, et al. Rupatadine in the treatment of chronic idiopathic urticaria: a double-blind, randomized, placebo-controlled multicentre study. Allergy. 2007 May;62:(5):539–546.
   PubMed Web of Science ®Google Scholar
• Dubertret L, Zalupca L, Cristodoulo T, et al. Once-daily rupatadine improves the symptoms of chronic idiopathic urticaria: a randomised, double-blind, placebo-controlled study. Eur J Dermatol. 2007 May;17:(3):223–228.
   PubMed Web of Science ®Google Scholar
• Ortonne JP, Grob JJ, Auquier P, et al. Efficacy and safety of desloratadine in adults with chronic idiopathic urticaria: a randomized, double-blind, placebo-controlled, multicenter trial. Am J Clin Dermatol. 2007;8(1):37–42. doi: 10.2165/00128071-200708010-00005
   PubMed Web of Science ®Google Scholar
• Monroe E, Finn A, Patel P, et al. Efficacy and safety of desloratadine 5 mg once daily in the treatment of chronic idiopathic urticaria: a double-blind, randomized, placebo-controlled trial. J Am Acad Dermatol. 2003 Apr;48:(4):535–541.
   PubMed Web of Science ®Google Scholar
• Ring J, Hein R, Gauger A, et al. Once-daily desloratadine improves the signs and symptoms of chronic idiopathic urticaria: a randomized, double-blind, placebo-controlled study. Int J Dermatol. 2001 Jan;40:(1):72–76.
   PubMed Web of Science ®Google Scholar
• Kaplan AP, Spector SL, Meeves S, et al. Once-daily fexofenadine treatment for chronic idiopathic urticaria: a multicenter, randomized, double-blind, placebo-controlled study. Ann Allergy Asthma Immunol. 2005 Jun;94:(6):662–669.
   PubMed Web of Science ®Google Scholar
• Nelson HS, Reynolds R, Mason J. Fexofenadine HCl is safe and effective for treatment of chronic idiopathic urticaria. Ann Allergy Asthma Immunol. 2000 May;84(5):517–522. doi: 10.1016/S1081-1206(10)62515-X
   PubMed Web of Science ®Google Scholar
• Shah B, Dhoot D, Choudhary A, et al. A comparative, three-arm, randomized clinical trial to evaluate the effectiveness and tolerability of bilastine vs fexofenadine vs levocetirizine at the standard dose and bilastine vs fexofenadine at higher than the standard dose (up-dosing) vs Levocetirizine and Hydroxyzine (in combination) in patients with chronic spontaneous urticaria. Clin Cosmet Investig Dermatol. 2022;15:261–270. doi: 10.2147/CCID.S350122
   PubMed Web of Science ®Google Scholar
• Zuberbier T, Oanta A, Bogacka E, et al. Comparison of the efficacy and safety of bilastine 20 mg vs levocetirizine 5 mg for the treatment of chronic idiopathic urticaria: a multi-centre, double-blind, randomized, placebo-controlled study. Allergy. 2010 Apr;65:(4):516–528.
   PubMed Web of Science ®Google Scholar
• Sil A, Rahaman S, Mondal N, et al. An investigator-blind randomized controlled trial comparing effectiveness, safety of levocetirizine and Bepotastine in chronic urticaria. Indian J Dermatol. 2021 Sep;66:(5):472–478.
   PubMed Web of Science ®Google Scholar
• Thi HT, Thi LP, Van TN, et al. The efficacy of a two-fold increase of H1-antihistamine in the treatment of chronic urticaria - the Vietnamese experience. Open Access Maced J Med Sci. 2019 Jan 30;7(2):259–263. doi: 10.3889/oamjms.2019.069
   PubMedGoogle Scholar
• Goyal V, Gupta A, Gupta O, et al. Comparative efficacy and safety of ebastine 20 mg, ebastine 10 mg and levocetirizine 5 mg in acute urticaria. J Clin Diagn Res. 2017 Mar;11:(3):WC06–WC09.
   PubMedGoogle Scholar
• Leynadier F, Duarte-Risselin C, Murrieta M. Comparative therapeutic effect and safety of mizolastine and loratadine in chronic idiopathic urticaria. URTILOR study group. Eur J Dermatol. 2000 Apr;10(3):205–211.
   PubMed Web of Science ®Google Scholar
• Yin R, Diao Q, Ye Q. Clinical research of three antihistamines in the treatment of chronic idiopathic urticaria. J Clin Dermatol (Nanjing). 2003;32:675–677.
   Google Scholar
• Hao F, Peng Z, Chen X. A multiple-center double-blind comparative clinical trial of desloratadine and loratadine for the treatment of chronic idiopathic urticaria. Chinese J Dermatovenereol. 2003;17:233–235.
   Google Scholar
• Pons-Guiraud A, Nekam K, Lahovsky J, et al. Emedastine difumarate versus loratadine in chronic idiopathic urticaria: a randomized, double-blind, controlled European multicentre clinical trial. Eur J Dermatol. 2006 Nov;16(6):649–654.
   PubMed Web of Science ®Google Scholar
• Fayaz SH, Varadarajan S, Ansari S, et al. Loratadine vs Rupatadine: unearthing the capital choice in chronic idiopathic urticaria (CIU) - a randomized controlled trial. Indian J Dermatol. 2021 Nov;66:(6):704.
   PubMed Web of Science ®Google Scholar
• Dakhale GN, Shinde AT, Mahatme MS, et al. Clinical effectiveness and safety of cetirizine versus rupatadine in chronic spontaneous urticaria: a randomized, double-blind, 6-week trial. Int J Dermatol. 2014 May;53:(5):643–649.
   PubMed Web of Science ®Google Scholar
• Maiti R, Jaida J, Raghavendra BN, et al. Rupatadine and levocetirizine in chronic idiopathic urticaria: a comparative study of efficacy and safety. J Drugs Dermatol. 2011 Dec;10(12):1444–1450.
   PubMed Web of Science ®Google Scholar
• Podder I, Das A, Ghosh S, et al. Effectiveness, safety, and tolerability of bilastine 20 mg vs levocetirizine 5 mg for the treatment of chronic spontaneous urticaria: a double-blind, parallel group, randomized controlled trial. Dermatol Ther. 2020 Nov;33:(6):e13946.
   PubMed Web of Science ®Google Scholar
• Mahawar DK, Aseri ML, Mathur S, et al. A prospective study of comparison of efficacy and safety between levocetirizine and olopatadine in chronic idiopathic urticaria. Indian J Allergy Asthma Immunol. 2014;28(2):86–92. doi: 10.4103/0972-6691.140783
   Google Scholar
• Anuradha P, Maiti R, Jyothirmai J, et al. Loratadine versus levocetirizine in chronic idiopathic urticaria: a comparative study of efficacy and safety. Indian J Pharmacol. 2010 Feb;42:(1):12–16.
   PubMed Web of Science ®Google Scholar
• Potter PC, Kapp A, Maurer M, et al. Comparison of the efficacy of levocetirizine 5 mg and desloratadine 5 mg in chronic idiopathic urticaria patients. Allergy. 2009 Apr;64:(4):596–604.
   PubMed Web of Science ®Google Scholar
• Dakhale GN, Wankhede SS, Mahatme MS, et al. Comparison of efficacy, safety and cost-effectiveness of rupatadine and olopatadine in patients of chronic spontaneous urticaria: a randomized, double-blind, comparative, parallel group trial. Indian J Dermatol. 2016 Jan;61:(1):63–69.
   PubMed Web of Science ®Google Scholar
• Sil A, Tripathi SK, Chaudhuri A, et al. Olopatadine versus levocetirizine in chronic urticaria: an observer-blind, randomized, controlled trial of effectiveness and safety. J DermatolTreat. 2013 Dec;24:(6):466–472.
   Google Scholar
• Handa S, Dogra S, Kumar B. Comparative efficacy of cetirizine and fexofenadine in the treatment of chronic idiopathic urticaria. J DermatolTreat. 2004 Jan;15(1):55–57. doi: 10.1080/09546630310013450
   Google Scholar
• Wang S, Liu Y, Wang J, et al. Clinical efficacy of levocetirizine combined with ebastine in the treatment of chronic urticaria and their effect on serum cytokines. Int J Clin Exp Med. 2019;12(9):11675–11683.
   Web of Science ®Google Scholar
• Zhang L, Wu J, Qi Y, et al. Long-term combinations and updosing of second-generation H(1)-antihistamines show efficacy and safety in the treatment of chronic spontaneous urticaria: a multicenter real-life pilot study. J Allergy Clin Immunol Pract. 2020 May;8:(5):1733–1736 e11.
   PubMed Web of Science ®Google Scholar
• Kim MA, Choi JH, Shin YS, et al. Efficacy of second-line treatments in chronic urticaria refractory to standard dose antihistamines. Allergy Asthma Immunol Res. 2023 Jul;15:(4):496–511.
   PubMed Web of Science ®Google Scholar
• Larenas-Linnemann D. Comparing antihistamines in chronic spontaneous urticaria: possible future directions. J Allergy Clin Immunol Pract. 2021 Jun;9(6):2272–2273. doi: 10.1016/j.jaip.2021.02.024
   PubMed Web of Science ®Google Scholar
• Chaichan W, Ruengorn C, Thavorn K, et al. Comparative safety profiles of individual second-generation H1-antihistamines for the treatment of chronic urticaria: a systematic review and network meta-analysis of randomized controlled trials. J Allergy Clin Immunol Pract. 2023 Aug;11:(8):2365–2381.
   PubMed Web of Science ®Google Scholar
• Xiong Y, Yuan Z, Yang J, et al. CYP3A5*3 and MDR1 C3435T are influencing factors of inter-subject variability in rupatadine pharmacokinetics in healthy Chinese volunteers. Eur J Drug Metab Pharmacokinet. 2016 Apr;41:(2):117–124.
   PubMed Web of Science ®Google Scholar
• Yi SY, Hong KS, Lim HS, et al. A variant 2677A allele of the MDR1 gene affects fexofenadine disposition. Clin Pharmacol Ther. 2004 Nov;76:(5):418–427.
   PubMed Web of Science ®Google Scholar
• Drescher S, Schaeffeler E, Hitzl M, et al. MDR1 gene polymorphisms and disposition of the P-glycoprotein substrate fexofenadine. Br J Clin Pharmacol. 2002 May;53:(5):526–534.
   PubMed Web of Science ®Google Scholar
• Akamine Y, Miura M, Sunagawa S, et al. Influence of drug-transporter polymorphisms on the pharmacokinetics of fexofenadine enantiomers. Xenobiotica. 2010 Nov;40:(11):782–789.
   PubMed Web of Science ®Google Scholar
• Chu JT. Histamine H1 receptor gene polymorphism acts as a biological indicator of the prediction of therapeutic efficacy in patients with allergic rhinitis in the Chinese Han population. J Cell Biochem. 2019 Jan;120(1):164–170. doi: 10.1002/jcb.27278
   PubMed Web of Science ®Google Scholar
• Fok JS, Kolkhir P, Church MK, et al. Predictors of treatment response in chronic spontaneous urticaria. Allergy. 2021 Oct;76:(10):2965–2981.
   PubMed Web of Science ®Google Scholar
• Ulambayar B, Yang EM, Cha HY, et al. Increased platelet activating factor levels in chronic spontaneous urticaria predicts refractoriness to antihistamine treatment: an observational study. Clin Transl Allergy. 2019;9(1):33. doi: 10.1186/s13601-019-0275-6
   PubMedGoogle Scholar
• Curto-Barredo L, Archilla LR, Vives GR, et al. Clinical features of chronic spontaneous urticaria that predict disease prognosis and refractoriness to standard treatment. Acta Derm Venereol. 2018 Jul 11;98(7):641–647. doi: 10.2340/00015555-2941
   PubMed Web of Science ®Google Scholar
• Kolkhir P, Altrichter S, Hawro T, et al. C-reactive protein is linked to disease activity, impact, and response to treatment in patients with chronic spontaneous urticaria. Allergy. 2018 Apr;73:(4):940–948.
   PubMed Web of Science ®Google Scholar
• de Montjoye L, Darrigade AS, Gimenez-Arnau A, et al. Correlations between disease activity, autoimmunity and biological parameters in patients with chronic spontaneous urticaria. Eur Ann Allergy Clin Immunol. 2021 Mar;53:(2):55–66.
   PubMed Web of Science ®Google Scholar
• Cugno M, Marzano AV, Tedeschi A, et al. Expression of tissue factor by eosinophils in patients with chronic urticaria. Int Arch Allergy Immunol. 2009;148(2):170–174. doi: 10.1159/000155748
   PubMed Web of Science ®Google Scholar
• Altrichter S, Frischbutter S, Fok JS, et al. The role of eosinophils in chronic spontaneous urticaria. J Allergy Clin Immunol. 2020 Jun;145:(6):1510–1516.
   PubMed Web of Science ®Google Scholar
• Asero R, Tedeschi A, Cugno M. Heparin and tranexamic acid therapy may be effective in treatment-resistant chronic urticaria with elevated d-dimer: a pilot study. Int Arch Allergy Immunol. 2010;152(4):384–389. doi: 10.1159/000292947
   PubMed Web of Science ®Google Scholar
• Asero R, Tedeschi A, Riboldi P, et al. Severe chronic urticaria is associated with elevated plasma levels of D-dimer. Allergy. 2008 Feb;63:(2):176–180.
   PubMed Web of Science ®Google Scholar
• Asero R. D-dimer: a biomarker for antihistamine-resistant chronic urticaria. J Allergy Clin Immunol. 2013 Oct;132(4):983–986. doi: 10.1016/j.jaci.2013.04.037
   PubMed Web of Science ®Google Scholar
• Kolkhir P, Pogorelov D, Olisova O. CRP, D-dimer, fibrinogen and ESR as predictive markers of response to standard doses of levocetirizine in patients with chronic spontaneous urticaria. Eur Ann Allergy Clin Immunol. 2017 Jul;49(4):189–192. doi: 10.23822/EurAnnACI.1764-1489.05
   PubMed Web of Science ®Google Scholar
• Baskurt D, Sarac E, Asero R, et al. D-dimer levels decline after immunosuppressive treatment rather than anticoagulant treatment in severe autoimmune chronic spontaneous urticaria. Eur Ann Allergy Clin Immunol. 2024 Jan;56:(1):42–44.
   PubMed Web of Science ®Google Scholar
• Maurer M, Staubach P, Raap U, et al. H1-antihistamine-refractory chronic spontaneous urticaria: it’s worse than we thought - first results of the multicenter real-life AWARE study. Clin Exp Allergy. 2017 May;47:(5):684–692.
   PubMed Web of Science ®Google Scholar
• Magen E, Mishal J, Zeldin Y, et al. Clinical and laboratory features of antihistamine-resistant chronic idiopathic urticaria. Allergy Asthma Proc. 2011 Nov;32:(6):460–466.
   PubMed Web of Science ®Google Scholar
• Ornek Ozdemir S, Kuteyla Can P, Degirmentepe EN, et al. A comparative analysis of chronic inducible urticaria in 423 patients: clinical and laboratory features and comorbid conditions. J Eur Acad Dermatol Venereol. 2024 Mar;38:(3):513–520.
   PubMedGoogle Scholar
• Manti S, Salpietro C, Cuppari C. Antihistamines: recommended dosage - divergence between clinical practice and guideline recommendations. Int Arch Allergy Immunol. 2019;178(1):93–96. doi: 10.1159/000492636
   PubMed Web of Science ®Google Scholar