The Itch: Allergies, Asthma, Eczema & Immunology

#78 - Chronic Spontaneous Urticaria Treatments


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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 chronic spontaneous urticaria: 

    • 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

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