Joseph Diaz, MD- Advances in Chronic Spontaneous Urticaria: Expert Insight on Translating Progress to Practice for Improved Symptom Control and Quality of Life

Go online to PeerView.com/HWY860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Chronic spontaneous urticaria (CSU) is defined by the presence of recurrent urticaria, angioedema, or both, for a period of 6 weeks or longer. There are several theories regarding the pathogenesis of CSU, none of which have been conclusively established. CSU is a self-limited disorder in most patients, with an average duration of disease of 2 to 5 years; although active CSU significantly impairs quality of life. Second-generation H1 antihistamines (sgAHs) in standard dose are effective in less than 50% of CSU patients. Increasing the dose of sgAHs improves treatment responses; however, every third to fourth patient will still remain symptomatic. Omalizumab, an anti-IgE monoclonal antibody, may also be used for effective treatment, as well as cyclosporine. The current guideline-recommended treatment algorithm, though useful, is not perfect. The treatment of patients with CSU should be individualized and take into account the likelihood of patients to respond to therapy, based on predictors of response. By choosing treatment options tailored to a patient’s clinical or biochemical characteristics, treatments that are less likely to be effective may be avoided. In this activity, based on a live symposium held at the AAD Annual Meeting in Boston, a panel of experts will discuss the selection of adequate and relevant tests for the diagnostic workup in CSU and novel treatment options for CSU in the context of mechanism of action, efficacy, and safety. In addition, they will take a closer look at treating CSU in accordance with current evidence and expert recommendations, recognizing that as the era of personalized treatment emerges, the best use for newer agents will be achieved with a deeper understanding of both the phenotype and endotype of each CSU patient. Upon completion of this activity, participants should be better able to: Select adequate and relevant tests for the diagnostic workup in chronic spontaneous urticaria (CSU) by obtaining a thorough medical history, Discuss how recent insights into the pathogenesis of CSU have led to the development of novel therapeutic targets, Describe novel treatment options for CSU in the context of mechanism of action, efficacy, and safety, Treat CSU in accordance with current evidence and expert recommendations, recognizing that as the era of personalized treatment emerges, the best use for newer agents will be achieved with a deeper understanding of both the phenotype and endotype of each CSU patient.