Prospective analysis of clinical evolution in chronic urticaria: Persistence, remission, recurrence, and pruritus alone

Sánchez, Jorge; Álvarez, Leidy; Cardona, Ricardo

doi:10.1016/j.waojou.2022.100705

Cited by 8 publications

(7 citation statements)

References 38 publications

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“…Various studies have employed different criteria for CSU remission (10). Published studies have shown that 30% to 80% of patients recover 1 to 5 years after symptom onset (2,3). Numerous studies have attempted to identify predictors of CSU prognosis.…”

Section: Discussionmentioning

confidence: 99%

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Remission of chronic urticaria in patients treated with omalizumab

Cvenkel,

Bizjak,

Šelb

et al. 2024

Acta Dermatovenerologica Alpina Pannonica Et Adriatica

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Chronic spontaneous urticaria (CSU) is characterized by the occurrence of itchy wheals, angioedema, or both, without identifiable triggers, persisting for at least 6 weeks (1). It usually occurs in the form of relapses and remissions. The more severe the disease, the lower the likelihood of its remission (2-4). CSU may significantly impair the quality of life (5). Disease activity is measured with the urticaria activity score (UAS). Daily UAS values can range from 0 to 6 points, depending on the number of wheals (0 to 3) and the intensity of pruritus (0 to 3) (5, 6). Treatment is aimed at complete control of the signs and symptoms (1). The primary medications are second-generation H1-antihistamines (sgAH), which are taken regularly in a dose of one to four tablets per day. Omalizumab is commonly used to treat patients with sgAH-resistant CSU. It is an anti-IgE humanized monoclonal antibody that lowers the concentration of free IgE and downregulates high-affinity receptors for IgE (FcεRI) on mast cells and basophils, preventing their degranulation (7). Omalizumab treatment is symptomatic and has no effect on the natural course of CSU (8). We aimed to observe the probability of disease remission in patients with sgAH-resistant CSU and its duration after discontinuation of omalizumab.

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Section: Discussionmentioning

confidence: 99%

“…severe and prolonged disease have a poorer prognosis than those with milder disease (2,3). Symptomatic dermographism carries the best prognosis, whereas cold urticaria has the poorest (9).…”

Section: Discussionmentioning

confidence: 99%

Remission of chronic urticaria in patients treated with omalizumab

Cvenkel,

Bizjak,

Šelb

et al. 2024

Acta Dermatovenerologica Alpina Pannonica Et Adriatica

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“…2 CSU is regarded as a self-resolving condition, as it tends to remit after 5-7 years. 3 Moreover, 25% of patients with CSU experience additional hives triggered by physical stimuli (chronic mixed urticaria, CMU). 1 Interestingly, in some CSU patients, the intake of NSAIDs with cyclooxygenase-1 (COX-1) inhibitory capacity also induces hives and/or angioedema.…”

Section: Backg Rou N Dmentioning

confidence: 99%

“…(chronic inducible urticaria, CIndU), whereas in 80% of individuals, the lesions occur without trigger (chronic spontaneous urticaria, CSU) 2 . CSU is regarded as a self‐resolving condition, as it tends to remit after 5–7 years 3 . Moreover, 25% of patients with CSU experience additional hives triggered by physical stimuli (chronic mixed urticaria, CMU) 1 .…”

Section: Introductionmentioning

confidence: 99%

Biomarkers predicting the controller dose of omalizumab in patients with chronic spontaneous urticaria

Zubiaga‐Fernandez,

Testera‐Montes,

Rondon

et al. 2024

Clin Experimental Allergy

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BackgroundClinical trials showed the efficacy of 300 mg/4 weeks of omalizumab (OMA) during 6 months in patients with severe chronic spontaneous urticaria (CSU). Nevertheless, in real life, many patients require higher doses and/or longer treatment. This study assesses the real‐life performance of OMA in severe CSU and identifies factors associated with the response.MethodsCSU patients eligible for OMA were recruited prospectively. Clinical data and a blood test were collected before OMA initiation. Urticaria Activity Score 7 (UAS7) was calculated at baseline and every 3 months during OMA treatment. CSU control was defined as UAS7 <7 points. This work was partially sponsored by OMA manufacturer.ResultsEighty‐nine adults (19.1% males) with severe CSU were recruited. Median duration of CSU prior to OMA initiation was 2 years, and median severity by UAS7 at baseline was 24 points (range 10–42 points). OMA controlled 94.4% of patients, but 17.9% of responders required doses >300 mg/4 weeks. A blood basophil count >20 cells/μL (OR 13.33; 95% CI 3.32–52.63; p < .001) and the absence of hypothyroidism (OR 3.65; 95% CI 0.78–16.95; p = .099) were identified as predictive factors to achieve control with 300 mg/4 weeks. Twelve patients were able to stop OMA during the study (responders in remission, RR). RR had received OMA for a median of 29 months (12–53 months). Conversely, 32 patients had been on OMA for >29 months at the end of the study (active responders, AR). AR had received OMA for a median of 45 months (30–100 months). There were no significant differences in clinical or analytical factors between RR and AR patients.ConclusionsLow blood basophil count and the presence of hypothyroidism might serve as biomarkers for the controller dose of OMA in severe CSU patients.

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“…La UCE se caracteriza por la sensación de prurito y la presencia de habones o angioedema (1)(2)(3)(4) . Un estudio reciente donde se reclutaron más de 600 pacientes con diagnóstico de UCE observó que el 23% de los pacientes realmente no tenían UCE, diagnóstico este que fue confundido en la mayoría de los casos con prurito crónico, prurigo y dermatitis atópica (12) . El error ocurre porque es frecuente que el paciente, al llegar a la consulta, no tiene lesiones y el diagnóstico se realiza solo a partir de su relato, el cual en ocasiones no da el mismo significado que el médico a términos como roncha, hinchazón, pápulas, entre otros.…”

Section: Confusión Con Otras Enfermedades Cutáneasunclassified

Barreras en el manejo de la urticaria crónica espontánea en la atención primaria. Desafíos y posibles soluciones

Sanchez,

García,

Tamayo

et al. 2023

rev. asoc. colomb. dermatol. cir. dematol.

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La Urticaria crónica espontánea (UCE) es una enfermedad con una alta carga de salud y alto impacto en la calidad de vida para los pacientes. En los últimos años, varias guías internacionales han desarrollado propuestas de tratamiento basadas en la mejor evidencia disponible. Sin embargo, las recomendaciones contenidas en estos documentos no siempre pueden ser aplicadas en la práctica médica, especialmente para los médicos de Atención Primaria. Cinco asociaciones científicas de Colombia buscaron identificar las posibles barreras que se le presentan a los médicos de Atención Primaria para el cumplimiento de las recomendaciones de las guías internacionales. Luego de realizar la identificación de las barreras, los autores plantearon algunas soluciones que podrían ayudar a conseguir un manejo oportuno para el paciente desde la Atención Primaria.

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Prospective analysis of clinical evolution in chronic urticaria: Persistence, remission, recurrence, and pruritus alone

Cited by 8 publications

References 38 publications

Remission of chronic urticaria in patients treated with omalizumab

Remission of chronic urticaria in patients treated with omalizumab

Biomarkers predicting the controller dose of omalizumab in patients with chronic spontaneous urticaria

Barreras en el manejo de la urticaria crónica espontánea en la atención primaria. Desafíos y posibles soluciones

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