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Cummings M. Acupuncture for Chronic Spontaneous Urticaria. Ann Intern Med 2023; 176:1674-1675. [PMID: 37956434 DOI: 10.7326/m23-2713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2023] Open
Affiliation(s)
- Mike Cummings
- British Medical Acupuncture Society, London, United Kingdom
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Zheng H, Xiao XJ, Shi YZ, Zhang LX, Cao W, Zheng QH, Zhong F, Hao PS, Huang Y, Chen ML, Zhang W, Zhou SY, Wang YJ, Wang C, Zhou L, Chen XQ, Yang ZQ, Zou ZH, Zhao L, Liang FR, Li Y. Efficacy of Acupuncture for Chronic Spontaneous Urticaria : A Randomized Controlled Trial. Ann Intern Med 2023; 176:1617-1624. [PMID: 37956431 DOI: 10.7326/m23-1043] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND The effectiveness of acupuncture for patients with chronic spontaneous urticaria (CSU), reported in a few small-scale studies, is not convincing. OBJECTIVE To investigate whether acupuncture leads to better effects on CSU than sham acupuncture or waitlist control. DESIGN A multicenter, randomized, sham-controlled trial. (Chinese Clinical Trial Registry: ChiCTR1900022994). SETTING Three teaching hospitals in China from 27 May 2019 to 30 July 2022. PARTICIPANTS 330 participants diagnosed with CSU. INTERVENTION Participants were randomly assigned in a 1:1:1 ratio to receive acupuncture, sham acupuncture, or waitlist control over an 8-week study period (4 weeks for treatment and another 4 weeks for follow-up). MEASUREMENTS The primary outcome was the mean change from baseline in the Weekly Urticaria Activity Score (UAS7) at week 4. Secondary outcomes included itch severity scores, self-rated improvement, and Dermatology Life Quality Index scores. RESULTS The mean change in UAS7 (range, 0 to 42) for acupuncture from baseline (mean score, 23.5 [95% CI, 21.8 to 25.2]) to week 4 (mean score, 15.3 [CI, 13.6 to 16.9]) was -8.2 (CI, -9.9 to -6.6). The mean changes in UAS7 for sham acupuncture and waitlist control from baseline (mean scores, 21.9 [CI, 20.2 to 23.6] and 22.1 [CI, 20.4 to 23.8], respectively) to week 4 (mean scores, 17.8 [CI, 16.1 to 19.5] and 20.0 [CI, 18.3 to 21.6], respectively) were -4.1 (CI, -5.8 to -2.4) and -2.2 (CI, -3.8 to -0.5), respectively. The mean differences between acupuncture and sham acupuncture and waitlist control were -4.1 (CI, -6.5 to -1.8) and -6.1 (CI, -8.4 to -3.7), respectively, which did not meet the threshold for minimal clinically important difference. Fifteen participants (13.6%) in the acupuncture group and none in the other groups reported adverse events. Adverse events were mild or transient. LIMITATION Lack of complete blinding, self-reported outcomes, limited generalizability because antihistamine use was disallowed, and short follow-up period. CONCLUSION Compared with sham acupuncture and waitlist control, acupuncture produced a greater improvement in UAS7, although the difference from control was not clinically significant. Increased adverse events were mild or transient. PRIMARY FUNDING SOURCE The National Key R&D Program of China and the Science and Technology Department of Sichuan Province.
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Affiliation(s)
- Hui Zheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China (H.Z., Y.-Z.S., W.C., Q.-H.Z., S.-Y.Z., Z.-H.Z., L.Z., F.-R.L., Y.L.)
| | - Xian-Jun Xiao
- College of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China (X.-J.X.)
| | - Yun-Zhou Shi
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China (H.Z., Y.-Z.S., W.C., Q.-H.Z., S.-Y.Z., Z.-H.Z., L.Z., F.-R.L., Y.L.)
| | - Lei-Xiao Zhang
- Internal Medicine of Integrated Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China (L.-X.Z.)
| | - Wei Cao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China (H.Z., Y.-Z.S., W.C., Q.-H.Z., S.-Y.Z., Z.-H.Z., L.Z., F.-R.L., Y.L.)
| | - Qian-Hua Zheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China (H.Z., Y.-Z.S., W.C., Q.-H.Z., S.-Y.Z., Z.-H.Z., L.Z., F.-R.L., Y.L.)
| | - Feng Zhong
- The First Hospital of Hunan University of Chinese Medicine, Changsha, China (F.Z., W.Z.)
| | - Ping-Sheng Hao
- Dermatology Department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China (P.-S.H., Y.H., M.-L.C.)
| | - Ying Huang
- Dermatology Department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China (P.-S.H., Y.H., M.-L.C.)
| | - Ming-Ling Chen
- Dermatology Department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China (P.-S.H., Y.H., M.-L.C.)
| | - Wei Zhang
- The First Hospital of Hunan University of Chinese Medicine, Changsha, China (F.Z., W.Z.)
| | - Si-Yuan Zhou
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China (H.Z., Y.-Z.S., W.C., Q.-H.Z., S.-Y.Z., Z.-H.Z., L.Z., F.-R.L., Y.L.)
| | - Yan-Jun Wang
- Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Hebei University of Chinese Medicine, Shijiazhuang, China (Y.-J.W.)
| | - Chuan Wang
- Wuhan No. 1 Hospital, Wuhan, China (C.W., L.Z.)
| | - Li Zhou
- Wuhan No. 1 Hospital, Wuhan, China (C.W., L.Z.)
| | - Xiao-Qin Chen
- No. 3 Affiliated Hospital of Chengdu University of Traditional Chinese Medicine (West District), Chengdu Pidu District Hospital of Traditional Chinese Medicine, Chengdu, China (X.-Q.C., Z.-Q.Y.)
| | - Zuo-Qin Yang
- No. 3 Affiliated Hospital of Chengdu University of Traditional Chinese Medicine (West District), Chengdu Pidu District Hospital of Traditional Chinese Medicine, Chengdu, China (X.-Q.C., Z.-Q.Y.)
| | - Zi-Hao Zou
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China (H.Z., Y.-Z.S., W.C., Q.-H.Z., S.-Y.Z., Z.-H.Z., L.Z., F.-R.L., Y.L.)
| | - Ling Zhao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China (H.Z., Y.-Z.S., W.C., Q.-H.Z., S.-Y.Z., Z.-H.Z., L.Z., F.-R.L., Y.L.)
| | - Fan-Rong Liang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China (H.Z., Y.-Z.S., W.C., Q.-H.Z., S.-Y.Z., Z.-H.Z., L.Z., F.-R.L., Y.L.)
| | - Ying Li
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China (H.Z., Y.-Z.S., W.C., Q.-H.Z., S.-Y.Z., Z.-H.Z., L.Z., F.-R.L., Y.L.)
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Lu Z, Zhou Q, Chai S, Yang H, Wang J, Luo H, Cao Y, Tao M. Efficacy and safety of Chinese medicine combined with acupuncture in the treatment of chronic urticaria: A meta-analysis. Medicine (Baltimore) 2022; 101:e30381. [PMID: 36086744 PMCID: PMC10980365 DOI: 10.1097/md.0000000000030381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 07/22/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Increasing studies have shown that Chinese medicine combined with acupuncture has a significant effect on chronic urticaria, which can treat both symptoms and root causes. This meta-analysis aims to compare the efficacy and safety differences between acupuncture combined with conventional Western medicine, so as to provide guidance for the clinical treatment of chronic urticaria. METHODS We searched Pubmed, Embase, Cochrane Library, CNKI, Wanfang, CQVIP, and CBM from the establishment of the database to August 2021. We included randomized controlled trial study that the experimental group was acupuncture combined with traditional Chinese medicine, while the control group was treated with conventional Western medicine. We excluded repeated publication, researches without full text, incomplete information, or inability to conduct data extraction and animal experiments, reviews, and systematic reviews. STATA 15.1 was used to analyze the data. RESULTS The pooled results show that total effective rate of acupuncture combined with traditional Chinese medicine group was significantly higher than that in the conventional Western medicine group (ratio rate [RR] = 1.29, 95% confidence interval [CI]: 1.2-1.38). Additionally, the pooled results show that Urticaria Activity Score (standardized mean difference = -1.51, 95% CI: -2.24 to -0.78) and pruritus score (standardized mean difference = -1.09, 95% CI: -1.71 to -0.47) of acupuncture combined with traditional Chinese medicine group was significantly lower than that in conventional Western medicine group, while there is no significant difference in wheal score between acupuncture combined with traditional Chinese medicine group and conventional Western medicine group. Importantly, the pooled results show that recurrence rate (RR = 0.35, 95% CI: 0.19-0.64) and the incidence of adverse events (RR = 0.27, 95% CI: 0.10-0.75) of acupuncture combined with traditional Chinese medicine group were all significantly lower than that in conventional Western medicine group. CONCLUSION Our research results found that traditional Chinese medicine combined with acupuncture has a more significant effect than conventional Western medicine and can significantly reduce the recurrence rate and the incidence of adverse reactions. The application of traditional Chinese medicine combined with acupuncture in the treatment of chronic urticaria should be further promoted.
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Affiliation(s)
- Zhenxiong Lu
- Yongkang Maternal and Child Health Care Hospita, Zhejiang Province, Jinhua, China
| | - Qiujun Zhou
- Department of First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Hangzhou, China 310000
| | - Shiqian Chai
- Department of First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Hangzhou, China 310000
| | - Huifeng Yang
- Department of First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Hangzhou, China 310000
| | - Jinhui Wang
- Wenzhou City Hospital of Traditional Chinese Medicine and Western Medicine Combined, Wenzhou, China
| | - Hongbin Luo
- Department of Dermatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yi Cao
- Department of Dermatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Maocan Tao
- Department of Dermatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
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Zheng Q, Zheng H, Zhou S, Shi Y, Zhang L, Xiao X, Zhang W, Zhou L, Huang Y, Chen M, Zhong F, Wang C, Li Y. Efficacy of acupuncture treatment for chronic spontaneous urticaria: study protocol for a randomised controlled trial. BMJ Open 2022; 12:e045027. [PMID: 35105558 PMCID: PMC8808388 DOI: 10.1136/bmjopen-2020-045027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Chronic spontaneous urticaria (CSU) is a troublesome dermatological problem that can have a significant impact on quality of life. Previous studies have indicated that acupuncture may be beneficial for patients with CSU. However, well-designed studies determine the effects of acupuncture on CSU are rare. The aim of this study is to investigate the efficacy and safety of acupuncture treatment for patients with CSU. METHODS AND ANALYSIS This study is designed as a multicentre, parallel, three-arm, randomised, sham-controlled trial. A total of 330 patients diagnosed as CSU will be randomly allocated into three groups: the verum acupuncture group, the sham acupuncture group and the waiting-list control group in a 1:1:1 ratio. Patients in the verum and sham acupuncture groups will receive 16 treatment sessions over 4 weeks, while patients in the waiting-list control group will not receive any acupuncture treatment. The primary outcome is the changes of weekly urticaria activity scores at the end of treatment. Secondary outcomes include itching severity measurement, Dermatology Life Quality Index, Hamilton Depression Scale, Hamilton Anxiety Scale, Pittsburgh Sleep Quality Index and serum total IgE level. Adverse events will be recorded during the study observation period. All patients who are randomised in this study will be included in the intention-to-treat analysis. ETHICS AND DISSEMINATION Ethical approval of this study has been granted by the Sichuan Regional Ethics Review of Committee on Traditional Chinese Medicine (TCM) (ID: 2019 kl-006), the Medical Ethic Committee of the First Hospital of Wuhan (ID: (2019) number 7)) and the Medical Ethics Committee of the First Hospital of Hunan University of TCM (ID: HN-LLKY-2019-017-01/03) in three clinical centres in China, respectively. The results will be disseminated through peer-reviewed journals. TRIAL REGISTRATION NUMBER ChiCTR1900022994.
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Affiliation(s)
- Qianhua Zheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Hui Zheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Siyuan Zhou
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yunzhou Shi
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Leixiao Zhang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xianjun Xiao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Wei Zhang
- Acupuncture, Tuina and Rehabilitation Department, The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Li Zhou
- Department of Acupuncture and Moxibustion, Wuhan Hospital of Traditional Chinese and Western Medicine, Wuhan, Hubei, China
| | - Ying Huang
- Dermatology Department, Chengdu University of Traditional Chinese Medicine Affiliated Hospital, Chengdu, Sichuan, China
| | - Mingling Chen
- Dermatology Department, Chengdu University of Traditional Chinese Medicine Affiliated Hospital, Chengdu, Sichuan, China
| | - Feng Zhong
- Acupuncture, Tuina and Rehabilitation Department, The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Chuan Wang
- Department of Acupuncture and Moxibustion, Wuhan Hospital of Traditional Chinese and Western Medicine, Wuhan, Hubei, China
| | - Ying Li
- Graduate School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Criado RFJ, Criado PR, Pagliari C, Sotto MN, Machado Filho CD, Bianco B. M2 macrophage polarization in chronic spontaneous urticaria refractory to antihistamine treatment. Allergol Int 2021; 70:504-506. [PMID: 33994101 DOI: 10.1016/j.alit.2021.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 03/23/2021] [Indexed: 12/17/2022] Open
Affiliation(s)
- Roberta F J Criado
- Department of Dermatology, Faculdade de Medicina do ABC, Santo André, SP, Brazil.
| | - Paulo Ricardo Criado
- Department of Dermatology, Faculdade de Medicina do ABC, Santo André, SP, Brazil
| | - Carla Pagliari
- Department of Pathology, Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Mirian N Sotto
- Department of Pathology, Faculdade de Medicina da Universidade de São Paulo, Brazil
| | | | - Bianca Bianco
- Department of Collective Health, Discipline of Sexual and Reproductive Health and Population Genetics, Faculdade de Medicina do ABC, Santo André, Brazil
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Pozderac I, Lugović-Mihić L, Artuković M, Stipić-Marković A, Kuna M, Ferček I. Chronic inducible urticaria: classification and prominent features of physical and non-physical types. Acta Dermatovenerol Alp Pannonica Adriat 2020; 29:141-148. [PMID: 32975301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Chronic inducible urticaria (CIndU) is a common inflammatory skin condition characterized by the recurrence of itchy wheals and/or angioedema that lasts more than 6 weeks and is induced by specific physical or environmental stimuli (cold, heat, exercise, pressure, sunlight, vibration, water, etc.). According to the current international classification, it includes physical urticarias (dermographism, delayed-pressure urticaria, exercise-induced urticaria, cold urticaria, heat urticaria, solar urticaria, and vibratory urticaria) and non-physical urticarias caused by exposure to specific stimuli (cholinergic urticaria, contact urticaria, and aquagenic urticaria). In terms of frequency, more common types of CIndU are dermographism, cholinergic urticaria, and delayed-pressure urticaria. In clinical practice, it is often difficult to define the exact type of CIndU; management thus begins with accurate identification of a possible trigger and its avoidance. The definite diagnosis for CIndU requires obtaining a detailed medical history of a patient with comprehensive information about predisposing factors, physical examination, and provocation testing (challenge tests). It is always necessary to recognize the prophylactic options for all the types and to have access to different therapies (primarily second-generation H1 antihistamines, but also H2 antihistamines, hydroxyzine, doxepin, oral glucocorticoids, omalizumab/anti-IgE therapy, phototherapy, physical desensitization, immunomodulatory agents, etc.) individualized for each patient.
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Affiliation(s)
- Iva Pozderac
- Clinical Department of Dermatovenereology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
- Clinical Department for Allergies, Clinical Immunology, and Pulmonology, Department of Internal Medicine, Special Hospital for Lung Diseases, Zagreb, Croatia
| | - Liborija Lugović-Mihić
- Clinical Department of Dermatovenereology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Marinko Artuković
- Clinical Department for Allergies, Clinical Immunology, and Pulmonology, Department of Internal Medicine, Special Hospital for Lung Diseases, Zagreb, Croatia
| | - Asja Stipić-Marković
- Clinical Department for Allergies, Clinical Immunology, and Pulmonology, Department of Internal Medicine, Special Hospital for Lung Diseases, Zagreb, Croatia
| | - Matea Kuna
- Clinical Department of Dermatovenereology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Iva Ferček
- Clinical Department of Dermatovenereology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
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Qin Y, Guo J, Song P, Hou T, He Y, Han M, Yu Q, Lin W, Chen M, Su H. Multi-center study for acupuncture combined with Chinese medicine in the treatment of chronic spontaneous urticaria based on the theory of taking shu-stream points when the disease is aggravated. Medicine (Baltimore) 2020; 99:e21266. [PMID: 32871985 PMCID: PMC7437762 DOI: 10.1097/md.0000000000021266] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Chronic spontaneous urticaria (CSU) is a common dermatologic disease that seriously affects patient quality of life. The choice of therapy to control the disease and prevent its recurrence has always presented a difficult clinical issue. Previous studies have shown that traditional Chinese medicine is a safe and effective treatment for CSU. Recently, the temporal rhythms of CSU, a disease characterized by intermittent flares of active disease and periods of little or no disease, have attracted the attention of traditional Chinese medicine researchers. We designed a multicenter, randomized, controlled study to evaluate the efficacy and safety of combining a Chinese herbal formulation with acupuncture using shu-stream acupoints applied on the corresponding time meridians during disease exacerbations. We plan to recruit 111 outpatients with CSU aged 18 to 65 years. Participants will be randomized to 1 of the 3 groups: group A, which will be given basic acupuncture and the herbal formulation dangui yinzi; group B, which will be given danggui yinzi and shu-stream acupuncture; and a control group, which will be given danggui yinzi alone. Patients will be treated for 4 weeks and followed for 8 additional weeks. Investigators will evaluate the following parameters: the symptoms and side effects of treatment, quality of life (using the chronic urticaria quality of life questionnaire), and overall patient condition. Each week, patients will also complete the measurement of 7-day urticarial activity score. This is the first use of a combination of shu-stream acupoints and Chinese herbal medicine in the treatment of CSU. If successful, it will prove to be a simple, inexpensive, treatment strategy for solving a difficult clinical problem.
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Affiliation(s)
- Yuesi Qin
- Hospital of Chengdu University of Traditional Chinese Medicine
- Chengdu Integrated TCM & Western Medicine Hospital
| | - Jing Guo
- Hospital of Chengdu University of Traditional Chinese Medicine
| | - Pan Song
- Chengdu Integrated TCM & Western Medicine Hospital
| | - Tianshu Hou
- Chengdu Integrated TCM & Western Medicine Hospital
| | - Yan He
- The First People's Hospital of Longquanyi District Chengdu
| | - Ming Han
- Xinjin County Hospital of traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Qianying Yu
- Hospital of Chengdu University of Traditional Chinese Medicine
| | - Wenxia Lin
- Hospital of Chengdu University of Traditional Chinese Medicine
| | - Mingling Chen
- Hospital of Chengdu University of Traditional Chinese Medicine
| | - Hong Su
- Chengdu Integrated TCM & Western Medicine Hospital
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Cao W, Xiao X, Zhang L, Wang L, Zheng Q, Zhou S, Liu Y, Cao Y, Chen M, Li C, Li Y. Acupoint injection of Bacillus Calmette-Guerin polysaccharide nucleic acid for patients with chronic urticaria: A protocol for systematic review. Medicine (Baltimore) 2020; 99:e19924. [PMID: 32358360 PMCID: PMC7440172 DOI: 10.1097/md.0000000000019924] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND To investigate the efficacy and safety of acupoint injection of Bacillus Calmette-Guerin polysaccharide nucleic acid (BCG-PSN) in the treatment of chronic urticaria (CU). METHODS The following databases will be searched from their inception: Medline, Embase, Pubmed, Web of Science, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure Database, China Biomedical Literature Database, China Science Journal Database, and Wanfang Database. All databases will be searched from the date of creation until October 2019. In addition, we will manually search the list of medical journals as a supplement. The scope of the search included randomized controlled clinical studies related to acupoint injection of BCG-PSN for CU. The primary outcome is the disease activity control. Secondary outcomes include response rate, adverse events, and recurrence rates. The Cochrane RevMan V5.3 Deviation Assessment Tool will be used to assess bias assessment risk, data integration risk, meta-analysis risk, and subgroup analysis risk (if conditions are met). The average difference, standard mean difference and binary data will be used to represent continuous results. RESULTS This study will comprehensively review the existing evidence on the treatment of CU by acupoint injection of BCG-PSN. CONCLUSION This systematic review will provide a judgment basis for the effectiveness and safety of acupoint injection of BCG-PSN in the treatment of CU. SYSTEMATIC REVIEW REGISTRATION PROSPERO, CRD42019139885.
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Affiliation(s)
- Wei Cao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Xianjun Xiao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
- Rehabilitation Department, The People's Hospital of Jianyang City
| | - Leixiao Zhang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Lu Wang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Qianhua Zheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Siyuan Zhou
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Ying Liu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Yue Cao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Mingling Chen
- Dermatological Department, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Chunxiao Li
- Dermatological Department, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Ying Li
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
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Goldstein S, Eftekhari S, Mitchell L, Winders TA, Kaufman L, Dudas D, Paknis B, Kavati A, Delwart V, Sofen HL. Perspectives on Living with Chronic Spontaneous Urticaria: From Onset through Diagnosis and Disease Management in the US. Acta Derm Venereol 2019; 99:1091-1098. [PMID: 31396637 DOI: 10.2340/00015555-3282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Chronic spontaneous urticaria is challenging to manage and substantially affects quality of life. This US, non-interventional qualitative study examined patients' clinical journeys and emotional burden from symptom onset through disease management. Chronic spontaneous urticaria patients participated in interviews and completed diaries focusing on disease and treatment history/perspectives, impact on personal/family life, and relationships with physicians/other healthcare providers. Physicians were interviewed about their views on disease management and patient care. Twenty-five patients, previously or currently receiving chronic spontaneous urticaria treatment(s), and 12 physicians participated. Key stages following symptom onset were identified: Crisis (associated with feelings of torment/disorientation/shock); Searching for answers (puzzlement/frustration/anxiety); Diagnosis (relief/satisfaction/fear/isolation); and Disease management (frustration/hope/powerlessness). Findings revealed patients' perceptions and experiences of chronic spontaneous urticaria, including living with a 'skinemy', experiencing their 'own personal hell' and feeling 'like an experiment'. Awareness of unmet needs in patient care/management identified in this study may ultimately improve patient support and enhance physicians' understanding of disease burden.
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Affiliation(s)
- Stanley Goldstein
- Allergy and Ashtma Care of Long Island, , 11570 Rockville Centre, USA.
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Hoskin B, Ortiz B, Paknis B, Kavati A. Exploring the real-world profile of refractory and non-refractory chronic idiopathic urticaria in the USA: clinical burden and healthcare resource use. Curr Med Res Opin 2019; 35:1387-1395. [PMID: 30793986 DOI: 10.1080/03007995.2019.1586222] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction: Chronic idiopathic/spontaneous urticaria (CIU/CSU) is a debilitating skin condition that is burdensome for patients and healthcare providers. We aimed to describe clinical characteristics, consultation patterns and healthcare resource utilization in real-world US patients with refractory and non-refractory CIU/CSU. Methods: Data was collected from the Adelphi Real World 2015 Urticaria Disease Specific Programme. Physicians completed patient record forms (PRFs) for the next four patients consulting with non-refractory CIU/CSU and the next six with refractory CIU/CSU; patients were considered refractory if symptomatic and on treatment step ≥2. The same patients were asked to complete patient self-completion (PSC) forms describing how CIU/CSU affected them. Results: Seventeen physicians (15 allergists; 2 dermatologists) completed 184 PRFs (108 refractory CIU/CSU; 76 non-refractory CIU/CSU); 140 patients completed PSC forms (93 refractory CIU/CSU; 47 non-refractory CIU/CSU). Mean time from first consultation to diagnosis was 13.5 (SD 28.3) weeks; mean time from diagnosis to first treatment was 16.0 (SD 37.9) weeks. Patients with refractory CIU/CSU were more likely to initially consult primary care physicians than those with non-refractory CIU/CSU (51% and 28%, respectively). The most common symptoms were itching, sleep problems and anxiety/distress, affecting 75%, 23% and 18%, respectively. Patient-perceived disease severity was greater than physician-perceived severity (refractory CIU/CSU kappa 0.1512; non-refractory CIU/CSU 0.1590). Conclusions: Patients with CIU/CSU in this real-world study - particularly those with refractory CIU/CSU - were slow to receive specialist care and had substantial symptom burdens; patient-physician perception of disease severity was discordant. Earlier diagnosis of CIU/CSU may lead to timely use of CIU/CSU therapies.
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Affiliation(s)
- Ben Hoskin
- a Adelphi Real World , Bollington Macclesfield , UK
| | - Benjamin Ortiz
- b Health Economics and Outcomes Research , Novartis Pharmaceuticals Corporation , East Hanover , NJ , USA
| | - Brandee Paknis
- b Health Economics and Outcomes Research , Novartis Pharmaceuticals Corporation , East Hanover , NJ , USA
| | - Abhishek Kavati
- b Health Economics and Outcomes Research , Novartis Pharmaceuticals Corporation , East Hanover , NJ , USA
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