First-Line Treatment of Acute Urticaria
This protocol covers the recommended first-line symptomatic management of acute urticaria, with the aim of completely preventing the occurrence of wheals and angioedema.
Treatment approach
First-line treatment centres on a modern 2nd-generation H1-antihistamine taken on a regular daily schedule to prevent wheal and angioedema formation. The complete structured regimen — including agent selection, dosing guidance, and monitoring parameters — is set out in the full protocol.
Full regimen and decision algorithm available via the protocol link below →
Treatment goal
Complete symptom control — consistent absence of wheals and pruritus — targeting a continuously maintained UAS = 0 and normalisation of quality of life.
References
DOI: 10.1111/all.70210
- We recommend a 2nd generation H1-antihistamine as first-line treatment for all types of urticaria.
- We recommend the use of a standard-dosed modern 2nd generation H1-antihistamines as the first-line symptomatic treatment for urticaria.
- Most, but not all 2nd generation H1-antihistamines have been tested specifically in urticaria, and evidence supports the use of bilastine, cetirizine, desloratadine, ebastine, fexofenadine, levocetirizine, loratadine, mizolastine, and rupatadine.
- We recommend aiming at complete symptom control in urticaria, considering as much as possible the safety and the quality of life of each individual patient.
- The goal of treatment is to treat the disease until it is gone, as efficiently and as safely as possible, aiming at a continuous complete control (consistently UAS = 0/UCT = 16) and a normalization of quality of life.
View source ↗