Management of Chronic Spontaneous Urticaria in Routine Clinical Practice Following the EAACI/GA(2)LEN/EDF/WAO Guidelines

Marín-Cabañas, Irene; Gracia, L. Berbegal-de; León-Marrero, F. de; Hispán, Patricia; Silvestre, J.F.

doi:10.1016/j.adengl.2017.03.014

Cited by 14 publications

(25 citation statements)

References 31 publications

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“…On average, only 50% of patients with CSU have an adequate response to nonsedating antihistamines at standard or up to fourfold doses, [52][53][54] and this percentage is even lower when angio-oedema is also present. 55 However, response rates do vary greatly across studies. A recent observational study demonstrated very low rates of disease control with standarddosed nonsedating antihistamines (18%), but favourable outcomes with higher doses in 74% of patients.…”

Section: Chronic Urticaria Is Often Resistant To Standard Treatmentmentioning

confidence: 99%

“…A recent observational study demonstrated very low rates of disease control with standarddosed nonsedating antihistamines (18%), but favourable outcomes with higher doses in 74% of patients. 55 In a systematic review, 60% of patients were unresponsive to standard-dosed nonsedating antihistamines, and updosing controlled pruritus but not the number of weals. 5 Up to one in four patients require treatment with omalizumab or ciclosporin, the third-and fourth-line therapies, respectively, according to the EAACI/GA 2 LEN/EDF/WAO urticaria guideline.…”

Section: Chronic Urticaria Is Often Resistant To Standard Treatmentmentioning

confidence: 99%

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The global burden of chronic urticaria for the patient and society*

et al. 2020

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Summary Chronic urticaria (CU) affects about 1% of the world population of all ages, mostly young and middle‐aged women. It usually lasts for several years (> 1 year in 25–75% of patients) and often takes > 1 year before effective management is implemented. It presents as chronic spontaneous urticaria (CSU), chronic inducible urticaria (CIndU) or both in the same person. More than 25% of cases are resistant to H1‐antihistamines, even at higher doses, and third‐ and fourth‐line therapies (omalizumab and ciclosporin) control the disease only in two‐thirds of H1‐antihistamine‐resistant patients. Here we review the impact of CU on different aspects of patients’ quality of life and the burden of this chronic disease for the patient and society. CU may have a strong impact on health‐related quality of life (HRQoL), particularly when CSU is associated with angio‐oedema and/or CIndU (Dermatology Life Quality Index > 10 in 30% of patients). Comorbidities, such as anxiety and depression, which are present in more than 30% of patients with CSU, compound HRQoL impairment. Severe pruritus and the unpredictable occurrence of weals and angio‐oedema are responsible for sleep disorders; sexual dysfunction; limitations on daily life, work and sports activities; interfering with life within the family and in society; and patients’ performance at school and work (6% absenteeism and 25% presenteeism). Apart from treatment costs, with annual values between 900 and 2400 purchasing power parity dollars (PPP$) in Europe and the USA, CU is associated with a high consumption of medical resources and other indirect costs, which may reach a total annual cost of PPP$ 15 550.

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Section: Chronic Urticaria Is Often Resistant To Standard Treatmentmentioning

confidence: 99%

Section: Chronic Urticaria Is Often Resistant To Standard Treatmentmentioning

confidence: 99%

The global burden of chronic urticaria for the patient and society*

et al. 2020

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“…we have included only those patients refractory to treatment with quadruple dose of antihistamines with systemic treatment prescribed by specialists (dermatology/allergology). Some authors have indicated that the percentage of patients who do not respond to antihistaminelicensed doses is set at about 30% 10. van den Elzen et al11 indicated that up to 49% of patients remained symptomatic after increasing the dose of anti-H1 by four times.…”

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confidence: 99%

Prevalence of chronic urticaria refractory to antihistamines in Andalucia, Spain

Pereyra‐Rodriguez

Gutiérrez

Armario‐Hita

et al. 2020

Dermatologic Therapy

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Chronic urticaria (CU) has a devastating effect on the quality of life of patients who suffer from it. The objective of this study is to determine the prevalence of severe chronic spontaneous urticaria (CSU) in adults in eight health areas in Andalucía. A retrospective observational study from January 2019 to December 2019 was conducted with the participation of seven reference hospitals that were analyzed, including a total reference population of 3 159 001 individuals ≥18 years. The analysis was carried out on the characteristics of the population and the estimated prevalence. In total, 369 patients with a diagnosis of CSU refractory to antagonist of histamine were registered. We have found a prevalence of refractory patients of 0.0012% (95% CI 0.0010%-0.0013), ranging from 0.006% to 0.02%. The present study has helped to describe the prevalence and characteristics of patients with severe urticarial. The prevalence is lower than previously reported. We have observed differences between hospital areas. There will be a new line of research at the national level to help improve the identification of patients with CSU.

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“…39.6% of patients receiving omalizumab gave adequate clinical response to omalizumab treatment alone without the need for antihistamine or montelukast treatment, this rate was similar to the literature. [6] We believe that our study will facilitate predicting the treatment responses of patients in clinical practice by shedding light on the distribution of chronic urticaria patients according to the treatment steps. The limitations of our study are as follows; urticaria activity score was not used in the evaluation of the treatment response, a subjective evaluation was made, the response to the treatment was based on clinical observational data and foods that played an important role in the etiological factors were not evaluated.…”

Section: Discussionmentioning

confidence: 93%

Turkey Urticaria Diagnosis and Treatment Guide based; Distribution of Chronic Urticaria Patients Treated in Our Clinic According to Step Therapy

Akyürek

Sarı

Kurtipek

et al. 2021

Journal of Contemporary Medicine

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Aim: Chronic urticaria is a condition that requires long-term treatment. In recent years, many countries have created their own guides to evaluate urticaria diagnosis and treatment approaches in an algorithm. In this study, we aimed to evaluate the distribution of patients with chronic urticaria treated in our clinic according to the treatment algorithm the "Turkey Urticaria Diagnosis and Treatment Guide" Material and Method: The files of the patients who applied to the dermatology clinic of our hospital and were followed up and treated with a diagnosis of chronic urticaria were investigated. Results: A total of 102 patients with chronic urticaria were included in the study. According to this guide, 17.6% of patients responded with standard dose antihistamine therapy, while the antihistamine dose given in 15.7% of patients was increased. The antihistamine treatment of 5.7% of patients was replaced by a different group of antihistamines at the same dose as the previous one. 52% of patients responded to omalizumab 300 mg/subcutaneous treatment every 28 days. However, 7.8% of the patients received omalizumab treatment every 14 days or cyclosporine treatment was required to be added to omalizumab treatment. Response to other treatments other than standard treatments was received in 1% of patients. Conclusion:We believe that our study will facilitate predicting the treatment responses of patients in clinical practice by shedding light on the distribution of chronic urticaria patients according to the treatment algorithm.

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Management of Chronic Spontaneous Urticaria in Routine Clinical Practice Following the EAACI/GA(2)LEN/EDF/WAO Guidelines

Cited by 14 publications

References 31 publications

The global burden of chronic urticaria for the patient and society*

The global burden of chronic urticaria for the patient and society*

Prevalence of chronic urticaria refractory to antihistamines in Andalucia, Spain

Turkey Urticaria Diagnosis and Treatment Guide based; Distribution of Chronic Urticaria Patients Treated in Our Clinic According to Step Therapy

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