Treatment of CSU
Treatment protocols were available for 213 patients (85.2%) (Table 2). Monotherapy was given to 161 (64.4%) and 52 (20.8%) received a combination of at least two medications. Of the 161 treated with monotherapy, 153 (95%) received antihistamine in the regular recommended dose and 7 (4.35%) received high dose antihistamines. One patient was treated with corticosteroids only. Of the 52 children treated with combination therapies, 32 (61.5%) received a regular dose of antihistamine and oral corticosteroids. Six patients needed a combination of three medications, 1 (16.66%) was treated with a combination that included omalizumab. Details regarding the treatment regimens are listed in Table 2.
Relapses were treated with regular dose antihistamines in 41.6%. However, relapsing patients used high dose antihistamine, or combination therapy more often (8.3% and 29.1%, respectively vs. 2.8% and 20.8% for the first episode, p=NS). Three of six patients who were treated with a combination of three medications in the first episode, suffered from relapse during the following years; significantly more than those treated with monotherapy or a combination of two medications (50% vs. 10.14%, p< 0.01, RR = 4.93).