Management of chronic spontaneous urticaria: practical parameters

被引:0
作者
Marzano, A. V. [1 ]
Pigatto, P. [2 ]
Cristaudo, A. [3 ]
Ayala, F. [4 ]
Rossi, O. [5 ]
Senna, G. [6 ]
Triggiani, M. [7 ]
Asero, R. [8 ]
机构
[1] Univ Milan, Osped Maggiore Policlin, Fdn IRCCS Ca Granda, Unit Dermatol,Dept Physiopathol & Transplantat, Milan, Italy
[2] Univ Milan, IRCCS Osped Galeazzi, Milan, Italy
[3] Ist Dermatol S Maria & S Gallicano, Rome, Italy
[4] Univ Naples Federico II, Dermatol Clin, Dipartimento Med Clin & Chirigia, Naples, Italy
[5] Univ Careggi, Azienda Osped, Allergy Unit, Florence, Italy
[6] Univ Integrata Verona, Azienda Osped, Unita Operat Dipartimentale Allergol, Verona, Italy
[7] Univ Salerno, Clin Allergol & Immunol, Internal Med, I-84100 Salerno, Italy
[8] Clin San Carlo Pademo Dugnano, Ambulatorio Allergol, Milan, Italy
来源
GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA | 2015年 / 150卷 / 02期
关键词
Urticaria; Histamine antagonists; Omalizumab; CHRONIC IDIOPATHIC URTICARIA; CHRONIC AUTOIMMUNE URTICARIA; SERUM SKIN-TEST; RESISTANT CHRONIC URTICARIA; LEUKOTRIENE RECEPTOR ANTAGONIST; CHRONIC UNREMITTING URTICARIA; DEPENDENT CHRONIC URTICARIA; PLACEBO-CONTROLLED TRIAL; HISTAMINE-INDUCED WHEAL; STEROID-SPARING AGENT;
D O I
暂无
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Chronic urticaria (CU) is a skin disorder characterized by transient, pruritic wheals persisting for longer than 6 weeks. According to the European Academy of Allergy and Clinical Immunology (EAACI) guidelines, CU can be categorized into two main types: chronic spontaneous urticaria (CSU), in which the wheals appear spontaneously, and inducible urticaria, that is triggered by physical agents. CSU may be due to triggering factors such as food allergens or infections, but in at least 40% of cases it is autoimmune in origin, caused by circulating autoantibodies anti-Fc epsilon R1 or anti-IgE, or autoreactive. In the present paper, re-evaluating the EAACI guidelines, we have developed a document containing some practical indications which are useful for diagnosis and management of CSU in the context of the Italian situation. Concerning CSU treatment, second generation antihistamines are the first-line treatment; these drugs can be used, as second-line treatment, at a higher than licensed dose in patients who do not respond adequately at licensed doses. The third-line treatment includes leukotriene receptor antagonists which, however, do not have a specific indication for the treatment of CSU, cyclosporine, whose use in this disease is still off-label, and omalizumab. The latter is a recombinant monoclonal IgG antibody that binds free IgE, down regulates mast cell function and induces eosinophil apoptosis. Recently, it has emerged as an effective and safe treatment for antihistamine-unresponsive CSU of both autoimmune/autoreactive and non-autoimmune/non-autoreactive, and has been officially approved for use against this disease.
引用
收藏
页码:237 / 246
页数:10
相关论文
共 50 条
[41]   Treatment of Chronic Spontaneous Urticaria [J].
Soter, Nicholas A. .
JOURNAL OF DRUGS IN DERMATOLOGY, 2015, 14 (04) :332-334
[42]   Treatment of Severely Recalcitrant Chronic Spontaneous Urticaria: A Discussion of Relevant Issues [J].
Wieder, Shira ;
Maurer, Marcus ;
Lebwohl, Mark .
AMERICAN JOURNAL OF CLINICAL DERMATOLOGY, 2015, 16 (01) :19-26
[43]   Evidence-Based Management of Chronic Urticaria in Children [J].
Pavic, Ivan ;
Hojsak, Iva ;
Cepin-Bogovic, Jasna .
PEDIATRIC ALLERGY IMMUNOLOGY AND PULMONOLOGY, 2012, 25 (04) :198-207
[44]   A Comparative Study of Sex Distribution, Autoimmunity, Blood, and Inflammatory Parameters in Chronic Spontaneous Urticaria with Angioedema and Chronic Histaminergic Angioedema [J].
Sabate-Bresco, Marina ;
Rodriguez-Garijo, Nuria ;
Azofra, Julian ;
Luisa Baeza, Maria ;
Donado, Carmen D. ;
Gaig, Pere ;
Guilarte, Mar ;
Herrera-Lasso, Valeria ;
Labrador-Horrillo, Moises ;
Sala-Cunill, Anna ;
Veleiro, Beatriz ;
Pilar Gil, Maria ;
Kaplan, Allen ;
Ferrer, Marta .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, 2021, 9 (06) :2284-2292
[45]   Management of chronic spontaneous urticaria (CSU): a treat to target approach using a patient reported outcome [J].
Lima, Hermenio ;
Gooderham, Melinda ;
Dutz, Jan ;
Lynde, Charles ;
Chapdelaine, Hugo ;
Ellis, Anne ;
Gilbert, Martin ;
Ho, Vincent ;
Papp, Kim ;
Poulin, Yves ;
Sussman, Gordon .
ALLERGY ASTHMA AND CLINICAL IMMUNOLOGY, 2017, 13
[46]   Chronic spontaneous urticaria: an autoimmune disease? A revision of the literature [J].
Di Lorenzo, Gabriele ;
Leto-Barone, Maria Stefania ;
La Piana, Simona ;
Seidita, Aurelio ;
Rini, Giovam Battista .
CLINICAL AND EXPERIMENTAL MEDICINE, 2013, 13 (03) :159-164
[47]   Therapy of antihistamine-resistant chronic spontaneous urticaria [J].
Greiwe, Justin ;
Bernstein, Jonathan A. .
EXPERT REVIEW OF CLINICAL IMMUNOLOGY, 2017, 13 (04) :311-318
[48]   Angioedema Indicates a Different Endotype of Chronic Spontaneous Urticaria [J].
Ornek, Sinem ;
Kocaturk, Emek .
ASTIM ALLERJI IMMUNOLOJI, 2022, 20 (02) :107-113
[49]   A stepwise approach in the management of chronic spontaneous urticaria in children [J].
Lee, Xin Hui Magdeline ;
Ong, Lin Xin ;
Cheong, Jing Yi Vanessa ;
Sultana, Rehena ;
Rao, Rajeshwar ;
Lim, Hwee Hoon ;
Ding, Xiao Mei ;
Loh, Wen Yin ;
Punan, Monika ;
Chiang, Wen Chin .
ASIA PACIFIC ALLERGY, 2016, 6 (01) :16-28
[50]   Biologics for the Use in Chronic Spontaneous Urticaria: When and Which [J].
Maurer, Marcus ;
Khan, David A. ;
Komi, Daniel Elieh Ali ;
Kaplan, Allen P. .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, 2021, 9 (03) :1067-1078