The predictive factors for remission of chronic spontaneous urticaria in childhood: Outcome from a prospective study

Abstract

Our study indicates that urticaria controlled by a standard dose of antihistamine can predict a good prognosis independently from disease duration at first visit.

Factors linked to disease severity and time to remission in patients with chronic spontaneous urticaria

“…This appears to be true also for children as reported by Eser and co‐workers who prospectively followed a total of 52 children with CSU over a period of 3 years. At 12 and 36 months, 33% and 48% of them showed remission, respectively, and the mean duration of disease at the first visit in patients who did not show remission after 3 years was higher than in those who did . In contrast, a previous study by Chansakulporn et al .…”

“…At 12 and 36 months, 33% and 48% of them showed remission, respectively, and the mean duration of disease at the first visit in patients who did not show remission after 3 years was higher than in those who did. 22 In contrast, a previous study by Chansakulporn et al 17 did not find duration of disease or other demographic variables to predict remission of CSU in children.…”

“…We found no published evidence that failure to respond to treatment in adult patients with CSU is linked to long disease duration. In children with CSU, remission rates of patients who respond to standard dosed antihistamine treatment are reportedly higher than those of patients who require high‐dose antihistamine or combination medications, indicating that urticaria controlled by a standard dose of antihistamine may predict a shorter time to remission in the paediatric CSU population …”

Biomarkers of treatment efficacy in patients with chronic spontaneous urticaria

“…In children with CSU, remission rates of patients who respond to standard dosed antihistamine treatment are reportedly higher than those of patients who require high-dose antihistamine or combination medications, indicating that urticaria controlled by a standard dose of antihistamine may predict a shorter time to remission in the pediatric CSU population. The mean duration of disease at the first visit in the non-remission group was higher than in the remission group, at the end of the study (19). An imbalance in pro-and anti-inflammatory adipokines in CU patients has been recently observed by Trinh and coworkers.…”

Hydroxychloroquine as a steroid-sparing agent in an infant with chronic urticaria

“…However, we believe this is unlikely given the severity of our patient’s urticaria and need for combination therapy, which are risk factors for persistent disease. 5,10 Furthermore, a recent study of children with CSU observed remission in only 10.6% and 44.5% of patients at 1 and 5 years, respectively. 5 Although further study is needed, this case demonstrates that hydroxychloroquine can be a safe and potentially effective therapeutic option for antihistamine-refractory CSU in children, allowing for concomitant discontinuation of steroids.…”