#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Guidelines of the Czech Society of Dermatology ČLS JEP and the Czech Society of Allergology and Clinical Immunology for the Treatment of Chronic Spontaneous Urticaria


Authors: N. Benáková 1,2;  Čds Skupina Pro Chronickou Urtikarii Pracovní;  Čsaki *
Authors‘ workplace: za ČSAKI: Dalibor Jílek, Irena Krčmová *;  za ČDS: Petr Arenberger, Nina Benáková, Olga Filipovská, Iva Karlová, Miroslav Nečas *;  Dermatovenerologická klinika 1. LF UK Praha přednosta prof. MUDr. Jiří Štork, CSc. 1;  Dermatologická ordinace alergoimunologického centra ImmunoFlow Praha vedoucí lékař MUDr. Martin Fuchs 2
Published in: Čes-slov Derm, 97, 2022, No. 3, p. 84-99
Category: Reviews (Continuing Medical Education)

Overview

Chronic spontaneous urticaria is relatively common disease with considerable impact on patient´s quality of life, impairing the performance at school, work and in daily life. Early diagnostics and early appropriate treatment are crucial for getting the disease and it’s symptoms under control. The update and revision of international guidelines for the treatment of chronic urticaria (2021) as a joint initiative of The European Academy of Allergy and Clinical Immunology (EAACI), Global Allergy and Asthma European Network (GA2LEN), European Dermatology Forum (EDF) and The Asia Pacific Association of Allergy, Asthma and Clinical Immunology (APAAACI) represent a suitable tool for clinical practice in the Czech Republic. Proven non-sedative 2nd generation antihistamines are the first line of therapy, even in increased dosage. These can be administered even by general practitioners as they are often the first physicians seen by the patient. Omalizumab is added to the antihistamine as a second line, and now also at higher doses. In the third line, cyclosporin A is in combination with an antihistamine. This treatment is in the competence of specialists in specialized centers.

Due to the interdisciplinary character of chronic urticaria, it is effective and beneficial to manage the treatment of patients with chronic urticaria not only by dermatologists, but also by allergologists and clinical immunologist, including higher-line treatments such as biologics and immunosuppressants and kinase inhibitors and other drugs in the future. The article was revised by the Expert Working Group of both professional societies and approved by the committees of The Czech Dermatovenerological Society and The Czech Society for Allergology and Clinical Immunology.


Sources

1. AGACHE, I., ROCHA, C., PEREIRA, A. et al. Efficacy and safety of treatment with omalizumab for chronic spontaneous urticaria: A systematic review for the EAACI Biologicals Guidelines. Allergy. 2021, 76 (1), s. 59–70.

2. AGACHE, I., AKDIS, C., AKDIS, M. et al. EAACI Biologicals Guidelines – Omalizumab for the treatment of chronic spontaneous urticaria in adults and in the paediatric population 12–17 years old. Allergy. 2022, 77, s. 17–38.

3. AGHDAM, M., VAN DEN BROEK, F., RIJKEN, F. et al. High-dose omalizumab use in patients with chronic spontaneous urticaria. J Allergy Clin Immunol Pract. 2019, 8, s. 426–427.

4. BAUER, A., DICKEL, H., JAKOB, T. et al. Expert consensus on practical aspects in the treatment of chronic urticaria Allergo Journal International. 2021, 30, s. 64–75.

5. BENÁKOVÁ, N. Současné praktické postupy pro vyšetřování a léčbu chronické urtikárie. Čs. Derm. 2015, 5, s. 177–224.

6. BERNSTEIN, J. A., SINGH, U., RAO, M. B., BERENDTS, K., ZHANG, X., MUTASIM, D. Benralizumab for Chronic Spontaneous Urticaria. N Engl J Med. 2020, 383 (14), s. 1389–1391.

7. BERNSTEIN, J. A., KAVATI, A., THARP, M. D. et al. Effectiveness of omalizumab in adolescent and adult patients with chronic spontaenous urticaria: a systematic review of „real-world“ evidence. Expert Opin Biol Ther. 2018, 18, s. 425–448.

8. CABALLERO, T. Medical algorithm. Management of C1 inhibitor hereditary angioedema. Allergy, 2022, 77 (3), s. 1060–1063.

9. CICARDI, M. et al. Classification, diagnosis and approach to treatment of angioedema. Allergy. 2014, 69, s. 602–616.

10. GABRIELI, S. Chronic urticaria in children can be controlled effectively with updosing second-generation antihistamines. J Am Acad Dermatol. 2020, 82 (6), s. 1535–1353.

11. GIMÉNEZ-ARNAU, A. M., VALERO, S. A., BARTRA, T. J. et al. Therapeutic strategy according to differences in response to omalizumab in patients with chronic spontaneous urticaria. J. Invest Allerg. Clin Imunol. 2019, 29, s. 338–348.

12. GONCALO, M. Chronic urticaria – From ‘Cinderella’ to a ‘Rock star’ in 30 years. JEADV, 2021, 35, s. 2259– 2260.

13. CHANG, J. et al. Management of Pediatric Chronic Spontaneous Urticaria: A Review of Current Evidence and Guidelines. J Asthma Allergy. 2021, 14, s. 187–199.

14. CHURCH, M. K., MAURER, M. H1 antihistamines and urticaria- how can we predict the best drug for our patient? Clin. Exp. Allerg. 2012, 42, s. 1423–1429.

15. KOLKHIR, P., ALTRICHTER, S., MUNOZ, M., HAWRO, T., MAURER, M. New treatments for chronic urticaria. Ann Allergy Asthma Immunol. 2020, 124, s. 2–12.

16. KOLKHIR, P., POGORELOV, D., DARLENSKI, R. et al. Management of chronic spontaneous urticaria: a worldwide perspective. World Allergy Organ J. 2018, 11(1), s. 14.

17. MAOZ-SEGAL, R., LEVY, T., HAJ-YAHIA, S., OFFENGENDEN, I., IANCOVICH-KIDON M., AGMON-LEVIN, N. Combination therapy with omalizumab and an immune-suppressive agent for resistant chronic spontaneous urticaria – A real-life experience. World Allergy Organ J. 2020, 13 (8),100448. (doi: 10.1016/j.waojou.2020.100448).

18. MAURER, M., PARISH, L. C. The dermatology view of hereditary angio-oedema: practical diagnostic and management considerations, JEADV, 2013, 27, s. 133–141.

19. MAURER, M. et al. Practical algorithm for diagnosing recurent wheals or angioedema. Allergy, 2013, 68, s. 816–819.

20. MAURER, M., RAAP, U., STAUBACH, P. Antihistamine-resistant chronic spontaneous urticaria: 1-year data from the AWARE study. Clin Exp Allergy. 2019, 49(5), s. 655–662.

21. METZ, M., VADASH, Z., KOCATÜRK, E, GIMÉNEZ-ARNAU, AM. Omalizumab updosing in chronic spontaneous urticaria: an overview of real-world evidence. Clin Rev Allergy Immunol. 2020, 59, s. 38–45.

22. PATIL, A. D., BINGEWAR, G., GOLDUST, M. Efficacy of methotrexate as add on therapy to H1 antihistamine in difficult to treat chronic urticaria: A systematic review and meta-analysis of randomized clinical trials. Dermatol Ther. 2020, 33 (6), e14077.

23. POWELL, R. J., LEECH, S. C., TILL, S., HUBER, P. A., NASSER, S. M., CLARK, A. T. BSACI guideline for the management of chronic urticaria and angioedema. Clin Exp Allergy. 2015, 45(3), s. 547–565.

24. SALMAN, A., COMERT, E. The real-life effectiveness and safety of omalizumab updosing in patients with chronic spontaneous urticaria. J Cutan Med Surg. 2019, 23(5), s. 496–500.

25. SARTI, L., BARNI, S., GIOVANNINI, M., LICCIOLI, G., NOVEMBRE, E., MORI, F. Efficacy and tolerability of the updosing of second-generation non-sedating H1 antihistamines in children with chronic spontaneous urticaria. Pediatr Allergy Immunol. 2021, 32 (1), s. 53–160.

26. SU, O., BAHALI, AG., ONSUN, N. The effect of at least 1-year use of omalizumab without interruption on relapse in patients with chronic spontaneous urticaria. Dermatol Ther. 2020, 33 (6), e14192.

27. TURK, M., KOCATURK, E., CURE, K. et al. Two-week intervals during omalizumab treatment may provide better symptom control in selected patients with chronic urticaria. J Allergy Clin Immunol Pract. 2018, 6(4), s. 1389–1390.

28. WELLER, K., ZUBERBIER, T., MAURER M. Chronic urticaria: tools to aid the diagnosis and assessment of disease status in daily practice. JEADV. 2015, 29, Suppl. 4, s. 38–44.

29. ZUBERBIER, T., ABERER, W., ASERO, R. et al. EAACI/ GA(2)LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis and management of urticaria. Allergy 2022, 30, s. 734–766.

30. YOSIPOVITCH, G., GREAVES, M. Chronic idiopathic urticaria. A “Cinderella” disease with a negative impact on quality of life and health care costs. Arch Dermatol. 2008, 144, s. 102–103.

Labels
Dermatology & STDs Paediatric dermatology & STDs
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#