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Table 2 Quality of Evidence and Strength of Recommendation for Use of Intervention Based on the GRADE System [182] (Updated to August, 2011)

From: Diagnosis and Treatment of Urticaria and Angioedema: A Worldwide Perspective

Drug

Quality of Evidence

Strength of Recommendation

Second-generation antihistamines (at licensed doses)

High

Strong (+)

First-generation antihistamines

High

Strong (-)

Second-generation antihistamines (at higher than licensed doses)

Moderate

Weak (+)

Anti-H2-antihistamines as add-on therapy

Moderate

Weak (+)

Oral corticosteroids (short course)

Low

Weak (+)

Oral corticosteroids

Very low

Strong (-)

Leukotriene receptor antagonists (as add-on therapy)

Low

Weak (+)

Anti-inflammatory agents (dapsone, sulfasalazine, hydroxychloroquine, colchicines, mycophenolate mofetil)

Low-very low

Weak (+)

Immunosuppressive agents

  

   Cyclosporine

Moderate

Weak (+)*

   Methotrexate

Very low

Weak (+)

   Cyclophosphamide

Very low

Weak (+)

Biologic agents

  

   Omalizumab,

Moderate

Weak (+)*

   IVIG

Low

Weak (+)

  1. (+), recommendation for medication; (-), recommendation against medication.
  2. *Although the recommendation is "weak" according to the GRADE approach, it is stronger than in other cases based on the quality of existing evidence.