Our Allergy, Asthma & Immunology Innovations podcast continues with the third episode of our chronic spontaneous urticaria (CSU) series. This episode focuses on the various medications that treat hives that last six weeks or longer.

Podcast co-hosts Kortney Kwong Hing and Payel Gupta, MD, of The Itch Podcast speak with Shaila Gogate, MD, a board-certified allergist and immunologist with Colorado Allergy & Asthma Centers in Denver. Dr. Gogate has also served as Assistant Professor of Clinical Medicine at the University of Colorado.

You can listen to or download the podcast on ItchPodcast.com for listening anytime, anywhere. The podcast can also be downloaded at:

We thank Novartis for sponsoring this episode.

Chronic spontaneous urticaria medication options

Dr. Gogate outlines the CSU treatment journey, focusing on shared decision-making between patients and providers. She discusses the importance of following treatment guidelines and adjusting medications as needed.

Chronic urticaria treatments include antihistamines, the biologic omalizumab, and cyclosporine.

This episode also explores managing CSU symptoms through both medical and non-medical approaches.


Key takeaways from this chronic spontaneous urticaria podcast

  • Get a clear understanding of how doctors start treating CSU. Dr. Gogate explains when and why medications are changed according to urticaria guidelines, starting with antihistamines, dosing, and potential side effects.
  • Find out about advanced treatments like omalizumab (Xolair® for hives) and cyclosporine, including dosing options and potential side effects.
  • Learn about the Urticaria Activity Score (UAS7) and its role in tracking CSU severity.
  • Get tips on improving quality of life through mental health screening and non-medical management strategies like stress reduction and special diets.


Podcast episode timestamps

  • 01:09 – How doctors start treating CSU
  • 02:26 – Antihistamines for hive treatment
  • 04:59 – When to change medications
  • 06:59 – Why antihistamines are used
  • 08:49 – How to pick the right antihistamine
  • 10:47 – Common side effects of antihistamines
  • 13:29 –  What to do if antihistamines don’t work
  • 16:09 –  How Omalizumab (Xolair) injections work
  • 17:59 – Using urticaria activity score (UAS7) to track CSU
  • 18:49 – Administering omalizumab at home vs. in-office
  • 21:24 – Possible side effects of omalizumab
  • 23:19 – How long to stay on a medication
  • 25:19 – Cyclosporine for urticaria treatment
  • 26:19 – New treatments in the pipeline, like remibrutinib and dupilumab
  • 27:39 – Checking mental health for CSU patients
  • 29:04 – Managing hives with less stress and special diets


Additional resources