The KAAACI/KDA Evidence-Based Practice Guidelines for Chronic Spontaneous Urticaria in Korean Adults and Children: Part 2. Management of H1-Antihistamine-Refractory Chronic Urticaria

被引：17

作者：

Choi, Jeong-Hee ^{[1
]}

Lee, Dong Hun ^{[2
]}

Song, Woo-Jung ^{[3
]}

Choi, Mira ^{[4
]}

Kwon, Jae-Woo ^{[5
]}

Kim, Gun-Woo ^{[6
]}

Kim, Myung Hwa ^{[7
]}

Kim, Mi-Ae ^{[8
]}

Kim, Min-Hye ^{[9
]}

Kim, Byung-Keun ^{[10
]}

Kim, Sujeong ^{[11
]}

Kim, Joung Soo ^{[12
]}

Kim, Jung Eun ^{[13
]}

Kim, Ju-Young ^{[14
]}

Kim, Joo-Hee ^{[15
]}

Kim, Hyun Jung ^{[16
]}

Kim, Hye One ^{[17
]}

Kim, Hyo-Bin ^{[18
]}

Roh, Joo Young ^{[19
]}

Park, Kyung Hee ^{[20
]}

Park, Kui Young ^{[21
]}

Park, Han-Ki ^{[22
]}

Park, Hyunsun ^{[23
]}

Bae, Jung Min ^{[24
]}

Byun, Ji Yeon ^{[25
]}

Song, Dae Jin ^{[26
]}

Ahn, Young Min ^{[27
]}

Lee, Seung Eun ^{[28
]}

Lee, Young Bok ^{[29
]}

Lee, Joong Sun ^{[30
]}

Lee, Ji Hyun ^{[31
]}

Lim, Kyung-Hwan ^{[32
]}

Youn, Sang Woong ^{[33
]}

Chang, Yoon-Seok ^{[34
]}

Jeon, You Hoon ^{[35
]}

Jeon, Jiehyun ^{[36
]}

Jue, Mihn-Sook ^{[37
]}

Choi, Sun Hee ^{[38
]}

Hur, Gyu-Young ^{[39
]}

Lim, Dae Hyun ^{[40
]}

Ye, Young-Min ^{[41
]}

Park, Young Min ^{[42
]}

机构：

[1] Hallym Univ, Dongtan Sacred Heart Hosp, Dept Pulmonol & Allergy, Allergy & Clin Immunol Res Ctr,Coll Med, Chunchon, South Korea

[2] Seoul Natl Univ, Seoul Natl Univ Hosp, Dept Dermatol, Coll Med, Seoul, South Korea

[3] Univ Ulsan, Asan Med Ctr, Dept Allergy & Clin Immunol, Coll Med, Seoul, South Korea

[4] Inje Univ, Ilsan Paik Hosp, Dept Dermatol, Ilsan, South Korea

[5] Kangwon Natl Univ, Sch Med, Dept Internal Med, Chunchon, South Korea

[6] St Carollo Gen Hosp, Dept Internal Med, Sunchon, South Korea

[7] Dankook Univ, Coll Med, Dept Dermatol, Cheonan, South Korea

[8] CHA Univ, CHA Bundang Med Ctr, Dept Pulmonol Allergy & Crit Care Med, Seongnam, South Korea

[9] Ewha Womans Univ, Coll Med, Dept Internal Med, Seoul, South Korea

[10] Korea Univ, Anam Hosp, Dept Internal Med, Med Ctr, Seoul, South Korea

[11] Kyungpook Natl Univ, Sch Med, Dept Internal Med, Daegu, South Korea

[12] Hanyang Univ, Guri Hosp, Dept Dermatol, Guri, South Korea

[13] Catholic Univ Korea, Eunpyeong St Marys Hosp, Coll Med, Dept Dermatol, Seoul, South Korea

[14] Gyeongsang Natl Univ, Changwon Hosp, Dept Internal Med, Div Pulmonol & Allergy, Chang Won, South Korea

[15] Hallym Univ, Sacred Heart Hosp, Div Pulm Allergy & Crit Care Med, Dept Med,Coll Med, Anyang, South Korea

[16] Korea Univ, Coll Med, Dept Prevent Med, Inst Evidence Based Med, Seoul, South Korea

[17] Hallym Univ, Coll Med, Dept Dermatol, Seoul, South Korea

[18] Inje Univ, Sanggye Paik Hosp, Dept Pediat, Seoul, South Korea

[19] Gachon Univ, Sch Med, Dept Dermatol, Gil Med Ctr, Incheon, South Korea

[20] Yonsei Univ, Dept Internal Med, Coll Med, Div Allergy & Immunol, Seoul, South Korea

[21] Chung Ang Univ, Dept Dermatol, Coll Med, Seoul, South Korea

[22] Kyungpook Natl Univ, Chilgok Hosp, Dept Allergy & Clin Immunol, Sch Med, Daegu, South Korea

[23] SMG SNU Boramae Med Ctr, Dept Dermatol, Seoul, South Korea

[24] Catholic Univ Korea, St Vincents Hosp, Coll Med, Dept Dermatol, Suwon, South Korea

[25] Ewha Womans Univ, Dept Dermatol, Coll Med, Seoul, South Korea

[26] Korea Univ, Dept Pediat, Coll Med, Seoul, South Korea

[27] Eulji Univ, Dept Pediat, Coll Med, Eulji Gen Hosp, Seoul, South Korea

[28] Pusan Natl Univ, Yangsan Hosp, Dept Internal Med, Div Pulmonol & Allergy, Yangsan, South Korea

[29] Catholic Univ Korea, Coll Med, Dept Dermatol, Seoul, South Korea

[30] Eulji Univ, Sch Med, Dept Dermatol, Daejeon, South Korea

[31] Catholic Univ Korea, Brain Korea 21 PLUS Project Med Sci, Seoul St Marys Hosp, Dept Dermatol,Coll Med, Seoul, South Korea

[32] Wirye Seoul Doctors Hosp, Seongnam, South Korea

[33] Seoul Natl Univ, Bundang Hosp, Dept Dermatol, Coll Med, Seongnam, South Korea

[34] Seoul Natl Univ, Bundang Hosp, Dept Internal Med, Coll Med, Seongnam, South Korea

[35] Hallym Univ, Dongtan Sacred Heart Hosp, Dept Pediat, Coll Med, Hwaseong, South Korea

[36] Korea Univ, Dept Dermatol, Coll Med, Seoul, South Korea

[37] Vet Hlth Serv Med Ctr, Dept Dermatol, Seoul, South Korea

[38] Kyung Hee Univ, Hosp Gangdong, Sch Med, Dept Pediat, Seoul, South Korea

[39] Korea Univ, Coll Med, Dept Internal Med, Seoul, South Korea

[40] Inha Univ, Sch Med, Dept Pediat, Incheon, South Korea

[41] Ajou Univ, Sch Med, Dept Allergy & Clin Immunol, 164 Worldcup Ro, Suwon 16499, South Korea

[42] Catholic Univ Korea, Seoul St Marys Hosp, Dept Dermatol, Coll Med, 222 Banpo Daero, Seoul 06591, South Korea

来源：

ALLERGY ASTHMA & IMMUNOLOGY RESEARCH | 2020年 / 12卷 / 05期

关键词：

Urticaria; antihistamine; treatment; guideline; evidence; leukotriene; IgE; cyclosporine; CHRONIC IDIOPATHIC URTICARIA; BAND ULTRAVIOLET-B; QUALITY-OF-LIFE; REFRACTORY CHRONIC URTICARIA; CYCLOSPORINE-A; DOUBLE-BLIND; OMALIZUMAB THERAPY; DOSE OMALIZUMAB; EFFICACY; ANTIHISTAMINE;

D O I：

10.4168/aair.2020.12.5.750

中图分类号：

R392 [医学免疫学];

学科分类号：

100102 ;

摘要：

Quite a few patients with chronic spontaneous urticaria (CSU) are refractory to H-1-antihistamines, even though the dose of H-1-antihistamines is increased up to 4-fold. CSU that is not controlled with H-1-antihistamines results in increased disease burden. Several immunomodulators have been used to manage these patients. The guidelines reported herein are connected to Part 1 of the KAAACI/KDA Evidence-Based Practice Guidelines for Chronic Spontaneous Urticaria in Korean Adults and Children, and aimed to provide evidence-based recommendations for the management of H-1-antihistamine-refractory CSU. Part 2 focuses on the more commonly used additional treatment options for refractory CSU, including omalizumab, cyclosporine, leukotriene receptor antagonist, dapsone, methotrexate, and phototherapy. The evidence to support their efficacy, dosing, safety, and selection of these agents is systematically reviewed. To date, for patients with refractory CSU, the methodologically sound data to evaluate the use of omalizumab has been growing; however, the evidence of other immunomodulators and phototherapy is still insufficient. Therefore, an individualized stepwise approach with a goal of achieving complete symptom control and minimizing side effects can be recommended. Larger controlled studies are needed to elevate the level of evidence to select a rational therapeutic agent for patients with refractory CSU.

引用

页码：750 / 770

页数：21

共 88 条

[21] Methotrexate-responsive chronic idiopathic urticaria: a report of two cases [J].