ArticleClinical and translational allergy2017
Effectiveness and safety of antihistamines up to fourfold or higher in treatment of chronic spontaneous urticaria.
Article in Clinical and translational allergy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 74 citations in OpenAlex.
- Rational Allergy Practice Guidelines by the Indian Academy of Pediatrics (IAP) and IAP-Allergy and Applied Immunology Chapter.Indian pediatrics · 2026Guideline
- Trial
- Healthcare Resource Utilization and Use of Biologics in Chronic Spontaneous Urticaria.The Journal of dermatology · 2026Article
- Serum Neuropeptides in Chronic Spontaneous Urticaria: Associations With Disease Activity and Clinical Phenotypes.Allergy, asthma & immunology research · 2026Article
- Approach to urticaria in primary care.Singapore medical journal · 2026Article
- Emerging IgE and non-IgE targeted therapies for chronic urticaria.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2026Review
- Lactobacillus paragasseri LG-1 Alleviates Urticaria-Like Symptoms in Mice via Modulation of Gut Microbiota, Hypoxanthine and Uric Acid.Microbial biotechnology · 2026Article
- Systemic Treatments for Chronic Spontaneous Urticaria: Anti-IgE and Beyond.The journal of allergy and clinical immunology. In practice · 2026Review
- Predictors of Super/Poor Omalizumab Response in Chinese Refractory Chronic Spontaneous Urticaria.Dermatology (Basel, Switzerland) · 2026Article
- Beyond Antihistamines: How Biologic and Small-Molecule Therapies Are Transforming Chronic Spontaneous Urticaria Care in Adults.Clinical drug investigation · 2025Review
- Urticaria Voices: Real-World Treatment Patterns and Outcomes in Chronic Spontaneous Urticaria.Dermatology and therapy · 2025Article
- Unveiling the immunopharmacological mechanisms of Danggui Yinzi (DGYZ) in treating chronic urticaria: insights from network pharmacology and experimental validation.Chinese medicine · 2025Article
- Clinical and molecular aspects of managing chronic spontaneous urticaria: identifying endotypes, phenotypes, and determinants of treatment response and resistance.Frontiers in allergy · 2025Review
- Association of Cardiovascular Disease and Chronic Spontaneous Urticaria: A Case-Control Study.American journal of clinical dermatology · 2024Article
- Predictive model to differentiate chronic histaminergic angioedema and chronic spontaneous urticaria with angioedema.The journal of allergy and clinical immunology. Global · 2024Article
- A Practical Approach to Diagnosing and Managing Chronic Spontaneous Urticaria.Dermatology and therapy · 2024Review
- Managing hyperglycemia and rash associated with alpelisib: expert consensus recommendations using the Delphi technique.NPJ breast cancer · 2024Article
- Effect of second-generation antihistamines on nighttime sleep and daytime sleepiness in patients with allergic rhinitis.Sleep & breathing = Schlaf & Atmung · 2023Article
- Disease burden and predictors associated with non-response to antihistamine-based therapy in chronic spontaneous urticaria.The World Allergy Organization journal · 2023Article
- Clinical Response to Low-dose Omalizumab Treatment in Chronic Spontaneous Urticaria: A Retrospective Study of 179 Patients.Acta dermato-venereologica · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTreatment with second-generation antihistamines is recommended in patients with chronic spontaneous urticaria (CSU). Some patients remain unresponsive even after up-dosing up to fourfold. Many third line treatment options have limited availability and/or give rise to significant side effects. We investigated effectiveness and safety of antihistamine treatment with dosages up to fourfold and higher.
methodsThis retrospective analysis of patients' records was performed in adult CSU patients suffering wheals and/or angioedema (AE). Demographic, clinical, and therapeutic data was extracted from their medical records. We recorded the type, maximum prescribed dosage, effectiveness, and reported side effects of antihistamine treatment.
resultsOf 200 screened patients, 178 were included. Treatment was commenced with a once daily dose of antihistamines. Persisting symptoms meant that up-dosing up to fourfold occurred in 138 (78%) of patients, yielding sufficient response in 41 (23%). Up-dosing antihistamines was necessary in 110 (80%) patient with weals alone or weals with angioedema and 28 (64%) with AE only (p = 0.039). Of the remaining 97 patients with insufficient response, 59 were treated with dosages higher than fourfold (median dosage 8, range 5-12). This was sufficient in 29 patients (49%). Side effects were reported in 36 patients (20%), whereof 30 (17%) experienced somnolence. Side effects after up-dosing higher than fourfold were reported in six out of 59 patients (10%).
conclusionUp-dosing antihistamines higher than fourfold dosage seems a feasible therapeutic option with regards to effectiveness and safety. The need for third line therapies could be decreased by 49%, with a very limited increase of reported side effects.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.