%0 Journal Article
%T S3 Guideline Urticaria. Part 2: Treatment of urticaria - German-language adaptation of the international S3 guideline.
%A Zuberbier T
%A Altrichter S
%A Bauer S
%A Brehler R
%A Brockow K
%A Dressler C
%A Fluhr J
%A Gaskins M
%A Hamelmann E
%A Kühne K
%A Merk H
%A Mülleneisen NK
%A Nast A
%A Olze H
%A Ott H
%A Pleimes M
%A Ruëff F
%A Staubach-Renz P
%A Wedi B
%A Maurer M
%J J Dtsch Dermatol Ges
%V 21
%N 2
%D 02 2023
%M 36730626
%F 5.231
%R 10.1111/ddg.14932
%X This publication is the second part of the German-language S3 guideline on urticaria. It covers the management of urticaria and should be used together with Part 1 of the guideline on classification and diagnosis. This publication was prepared according to the criteria of the AWMF on the basis of the international English-language S3 guideline with special consideration of health system conditions in German-speaking countries. Chronic urticaria has a high impact on the quality of life and daily activities of patients. Therefore, if causal factors cannot be eliminated, effective symptomatic treatment is necessary. The recommended first-line treatment is to administer new generation, non-sedating H1 antihistamines. If the standard dose is not sufficiently effective, the dose should be increased up to fourfold. For patients who do not respond to this treatment, the second-line treatment in addition to antihistamines in the treatment algorithm is omalizumab and, if this treatment fails, ciclosporin. Other low-evidence therapeutic agents should only be used if all treatments in the treatment algorithm agreed upon by the guideline group fail. Both the benefit-risk profile and cost should be considered. Corticosteroids are not recommended for long-term treatment due to their inevitable severe side effects.