Use of nonbiologic treatments in antihistamine-refractory chronic urticaria: a review of published evidence
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02.01.2018 |
Holm J.
Ivyanskiy I.
Thomsen S.
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Journal of Dermatological Treatment |
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6 |
Ссылка
© 2017 Informa UK Limited, trading as Taylor & Francis Group. Background: Knowledge of effectiveness and safety of the nonbiologic, nonantihistamine treatments used for chronic urticaria is important as in some cases the principal guideline-recommended drug; omalizumab, has limited effect, side effects or is too expensive or unavailable. Herein, we systematically review the evidence for the use of the nonbiologic treatments in antihistamine-refractory chronic urticaria. Methods: We performed a systematic review of the literature using PubMed and Webofscience and identified studies that reported use of one or more of the nonbiological, nonantihistamine treatment options for chronic urticaria. The studies were evaluated based on study design, number of patients, effect of treatment and safety. Results: We identified 118 studies or case series with 13 different treatments (azathioprine, chloroquine, colchicine, cyclosporine, dapsone, intravenous immunoglobulin (IVIG), methotrexate, montelukast, mycophenolate mofetil, plasmapheresis, sulfasalazine, tranexamic acid and ultraviolet light (UV) A, UVB) totaling 1682 patients. There was a paucity of controlled trials for most of the treatments reviewed albeit the strongest evidence in favor of a beneficial effect in chronic urticaria was, apart from montelukast and cyclosporine, seen for UV therapy and dapsone followed by IVIG. Conclusion: The treatment options reviewed should be seen as potential alternatives in treatment-resistant chronic urticaria where guideline-based selections have failed. However, larger controlled trials are warranted to advance the level of evidence, possibly supporting some treatments’ future recommendation in selected patients.
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Important problems in the diagnosis and treatment of autoimmune hepatitis (based on the Russian consensus 2017)
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01.01.2018 |
Vinnitskaya E.
Sandler Y.
Bakulin I.
Parfenov A.
Nikitin I.
Ilchenko L.
Bueverov A.
Lopatkina T.
Ignatova
Syutkin V.
Raikhelson K.
Khomeriki S.
Gudkova R.
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Terapevticheskii Arkhiv |
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0 |
Ссылка
© 2018 Media Sphera Publishing Group. All rights reserved. The analysis of publications devoted to the Russian Consensus on the Diagnostic and Treatment of Autoimmune Hepatitis (AIH), which was considered at the 43rd annual Scientific Session of the CNIIG From Traditions to Innovation (March 4, 2017) is carried out. The presence of clear algorithms and recommendations for the diagnosis and treatment of AIH significantly help the doctor in real clinical practice, but do not exclude a personified approach to the patient.
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