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Gonçalo M, Gimenéz‐Arnau A, Al‐Ahmad M, Ben‐Shoshan M, Bernstein J, Ensina L, Fomina D, Galvàn C, Godse K, Grattan C, Hide M, Katelaris C, Khoshkhui M, Kocatürk E, Kulthanan K, Medina I, Nasr I, Peter J, Staubach P, Wang L, Weller K, Maurer M. The global burden of chronic urticaria for the patient and society*. Br J Dermatol 2020; 184:226-236. [DOI: 10.1111/bjd.19561] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2020] [Indexed: 02/07/2023]
Affiliation(s)
- M. Gonçalo
- Department of Dermatology University Hospital and Faculty of MedicineUniversity of Coimbra Coimbra Portugal
| | - A. Gimenéz‐Arnau
- Department of Dermatology Hospital del MarIMIMUniversitat Autònoma Barcelona Spain
| | - M. Al‐Ahmad
- Microbiology Department Faculty of Medicine Kuwait University Kuwait
| | - M. Ben‐Shoshan
- Division of Allergy, Immunology and Dermatology Department of Pediatrics Montreal Children’s HospitalMcGill University Montréal QC Canada
| | - J.A. Bernstein
- University of Cincinnati College of MedicineDepartment of Internal Medicine, Division of Immunology/Allergy Section, Partner Bernstein Allergy Group and Bernstein Clinical Research Center Cincinnati OH USA
| | - L.F. Ensina
- Alergoalpha/CPAlpha Allergy Clinic and Clinical Research Center and Division of Allergy, Clinical Immunology and Rheumatology Department of Pediatrics Federal University of São Paulo (UNIFESP/EPM) São Paulo SP Brazil
| | - D. Fomina
- Moscow City Center of Allergy and Immunology Clinical City Hospital #52 Department of General Therapy Pirogov Russian National Research Medical University Moscow Russian Federation
- Department of Allergology and Clinical Immunology I.M. Sechenov First Moscow State Medical University Moscow Russian Federation
| | - C.A. Galvàn
- Instituto Nacional de Salud del NiñoCentro de Referencia Nacional de Alergia Asma e Inmunología, Lima Perú
| | - K. Godse
- Department of Dermatology Dr D.Y. Patil School of Medicine Mumbai Maharashtra India
| | - C. Grattan
- St John’s Institute of DermatologyGuy’s Hospital London UK
| | - M. Hide
- Department of Dermatology Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - C.H. Katelaris
- Campbelltown Hospital and Western Sydney University Sydney NSW Australia
| | - M. Khoshkhui
- Allergy Research Center Mashhad University of Medical Sciences Mashhad Iran
| | - E. Kocatürk
- Department of Dermatology Koc University School of Medicine Istanbul Turkey
| | - K. Kulthanan
- Department of Dermatology Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand
| | - I. Medina
- Centro Medico VitaeDepartment of Allergy and Clinical Immunology Buenos Aires Argentina
| | - I. Nasr
- Department of Immunology and Allergy Royal Hospital Muscat Oman
| | - J. Peter
- Division of Allergy and Clinical Immunology University of Cape Town and Allergy and Immunology UnitUniversity of Cape Town Lung Institute Cape Town South Africa
| | - P. Staubach
- Department of Dermatology University Medical Center Mainz Mainz Germany
| | - L. Wang
- Liangchun Wang – Sun Yat‐sen Memorial Hospital Sun Yat‐sen University Guangzhou China
| | - K. Weller
- Dermatological Allergology Allergie‐Centrum‐Charité Department of Dermatology and Allergy Charité – Universitätsmedizin Berlin Berlin Germany
| | - M. Maurer
- Dermatological Allergology Allergie‐Centrum‐Charité Department of Dermatology and Allergy Charité – Universitätsmedizin Berlin Berlin Germany
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Weller K, Giménez‐Arnau A, Grattan C, Asero R, Mathelier‐Fusade P, Bizjak M, Hanna M, Maurer M. The Chronic Urticaria Registry: rationale, methods and initial implementation. J Eur Acad Dermatol Venereol 2020; 35:721-729. [DOI: 10.1111/jdv.16947] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/24/2020] [Indexed: 11/26/2022]
Affiliation(s)
- K. Weller
- Dermatological Allergology Allergie‐Centrum‐Charité Department of Dermatology and Allergy Charité ‐ Universitätsmedizin Berlin Berlin Germany
| | - A. Giménez‐Arnau
- Department of Dermatology, Hospital del Mar Autonomous University of Barcelona Barcelona Spain
| | - C. Grattan
- St John's Institute of Dermatology London UK
| | - R. Asero
- Outpatient Clinic of Allergology San Carlo Hospital Paderno Dugnano Italy
| | | | - M. Bizjak
- University Clinic of Respiratory and Allergic Diseases Golnik Golnik Slovenia
| | - M. Hanna
- Mercury Medical Research & Writing New York NY USA
| | - M. Maurer
- Dermatological Allergology Allergie‐Centrum‐Charité Department of Dermatology and Allergy Charité ‐ Universitätsmedizin Berlin Berlin Germany
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Bousquet J, Akdis CA, Grattan C, Eigenmann PA, Hoffmann-Sommergruber K, Hellings PW, Agache I. Highlights and recent developments in airway diseases in EAACI journals (2017). Clin Transl Allergy 2018; 8:49. [PMID: 30498567 PMCID: PMC6258432 DOI: 10.1186/s13601-018-0238-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 11/16/2018] [Indexed: 12/21/2022] Open
Abstract
The European Academy of Allergy and Clinical Immunology (EAACI) owns three journals: Allergy, Pediatric Allergy and Immunology and Clinical and Translational Allergy. One of the major goals of EAACI is to support health promotion in which prevention of allergy and asthma plays a critical role and to disseminate the knowledge of allergy to all stakeholders including the EAACI junior members. There was substantial progress in 2017 in the identification of basic mechanisms of allergic and respiratory disease and the translation of these mechanisms into clinics. Better understanding of molecular and cellular mechanisms, efforts for the development of biomarkers for disease prediction, novel prevention and intervention studies, elucidation of mechanisms of multimorbidies, entrance of new drugs in the clinics as well as recently completed phase three clinical studies and publication of a large number of allergen immunotherapy studies and metaanalyses have been the highlights of the last year.
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Affiliation(s)
- J Bousquet
- MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France.,INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, France.,3UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Montigny le Bretonneux, France.,Euforea, Brussels, Belgium.,CHRU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
| | - C A Akdis
- 5Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Davos, Switzerland
| | - C Grattan
- 6St John's Institute of Dermatology, Guy's Hospital, London, UK
| | - P A Eigenmann
- 7Pediatric Allergy Unit, University Hospitals of Geneva, Geneva, Switzerland
| | - K Hoffmann-Sommergruber
- 8Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - P W Hellings
- Euforea, Brussels, Belgium.,9Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Louvain, Belgium
| | - I Agache
- 10Transylvania University Brasov, Brasov, Romania
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4
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Sussman G, Abuzakouk M, Bérard F, Canonica W, Oude Elberink H, Giménez-Arnau A, Grattan C, Hollis K, Hunter S, Knulst A, Lacour JP, Lynde C, Marsland A, McBride D, Maurer M, Nakonechna A, Ortiz de Frutos J, Reynolds M, Sweeney C, Tian H, Weller K, Wolin D, Balp MM. Angioedema in chronic spontaneous urticaria is underdiagnosed and has a substantial impact: Analyses from ASSURE-CSU. Allergy 2018; 73:1724-1734. [PMID: 29460968 PMCID: PMC6055840 DOI: 10.1111/all.13430] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2018] [Indexed: 12/13/2022]
Abstract
Background ASSURE‐CSU revealed differences in physician and patient reporting of angioedema. This post hoc analysis was conducted to evaluate the actual rate of angioedema in the study population and explore differences between patients with and without angioedema. Methods This international observational study assessed 673 patients with inadequately controlled chronic spontaneous urticaria (CSU). Physicians abstracted angioedema data from medical records, which were compared with patient‐reported data. Patients in the Yes‐angioedema category had angioedema reported in the medical record and a patient‐reported source. For those in the No‐angioedema category, angioedema was reported in neither the medical record nor a patient‐reported source. Those in the Misaligned category had angioedema reported in only one source. Statistical comparisons between Yes‐angioedema and No‐angioedema categories were conducted for measures of CSU activity, health‐related quality of life (HRQoL), productivity and healthcare resource utilization (HCRU). Regression analyses explored the relationship between Dermatology Life Quality Index (DLQI) score and angioedema, adjusting for important covariates. Results Among evaluable patients, 259 (40.3%), 173 (26.9%) and 211 (32.8%) were in the Yes‐angioedema, No‐angioedema and Misaligned category, respectively. CSU activity and impact on HRQoL, productivity, and HCRU was greater for Yes‐angioedema patients than No‐angioedema patients. After covariate adjustment, mean DLQI score was significantly higher (indicating worse HRQoL) for patients with angioedema versus no angioedema (9.88 vs 7.27, P < .001). The Misaligned category had similar results with Yes‐angioedema on all outcomes. Conclusions Angioedema in CSU seems to be under‐reported but has significant negative impacts on HRQoL, daily activities, HCRU and work compared with no angioedema.
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Affiliation(s)
- G. Sussman
- University of Toronto; Toronto ON Canada
| | | | - F. Bérard
- Claude Bernard University Lyon; Villeurbanne France
| | - W. Canonica
- IRCCS-Humanitas Research Hospital; Humanitas University; Rozzano-Milano Italy
| | - H. Oude Elberink
- Department of Allergology; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
- GRIAC Research Institute; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| | | | | | - K. Hollis
- RTI Health Solutions; Research Triangle Park NC USA
| | - S. Hunter
- RTI Health Solutions; Research Triangle Park NC USA
| | - A. Knulst
- University Medical Center; Utrecht The Netherlands
| | | | - C. Lynde
- Lynderm Research; Toronto ON Canada
| | - A. Marsland
- Salford Royal Hospital; University of Manchester; Salford UK
| | | | - M. Maurer
- Charité - Universitätsmedizin Berlin; Berlin Germany
| | - A. Nakonechna
- Royal Liverpool and Broadgreen University Hospitals; Liverpool UK
| | | | - M. Reynolds
- RTI Health Solutions; Research Triangle Park NC USA
| | - C. Sweeney
- RTI Health Solutions; Research Triangle Park NC USA
| | - H. Tian
- Novartis Pharmaceuticals Corporation; East Hanover NJ USA
| | - K. Weller
- Charité - Universitätsmedizin Berlin; Berlin Germany
| | - D. Wolin
- RTI Health Solutions; Research Triangle Park NC USA
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5
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Zuberbier T, Aberer W, Asero R, Abdul Latiff AH, Baker D, Ballmer-Weber B, Bernstein JA, Bindslev-Jensen C, Brzoza Z, Buense Bedrikow R, Canonica GW, Church MK, Craig T, Danilycheva IV, Dressler C, Ensina LF, Giménez-Arnau A, Godse K, Gonçalo M, Grattan C, Hebert J, Hide M, Kaplan A, Kapp A, Katelaris CH, Kocatürk E, Kulthanan K, Larenas-Linnemann D, Leslie TA, Magerl M, Mathelier-Fusade P, Meshkova RY, Metz M, Nast A, Nettis E, Oude-Elberink H, Rosumeck S, Saini SS, Sánchez-Borges M, Schmid-Grendelmeier P, Staubach P, Sussman G, Toubi E, Vena GA, Vestergaard C, Wedi B, Werner RN, Zhao Z, Maurer M. The EAACI/GA²LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy 2018; 73:1393-1414. [PMID: 29336054 DOI: 10.1111/all.13397] [Citation(s) in RCA: 767] [Impact Index Per Article: 127.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2017] [Indexed: 02/06/2023]
Abstract
This evidence- and consensus-based guideline was developed following the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. The conference was held on 1 December 2016. It is a joint initiative of the Dermatology Section of the European Academy of Allergology and Clinical Immunology (EAACI), the EU-founded network of excellence, the Global Allergy and Asthma European Network (GA²LEN), the European Dermatology Forum (EDF) and the World Allergy Organization (WAO) with the participation of 48 delegates of 42 national and international societies. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS). Urticaria is a frequent, mast cell-driven disease, presenting with wheals, angioedema, or both. The lifetime prevalence for acute urticaria is approximately 20%. Chronic spontaneous urticaria and other chronic forms of urticaria are disabling, impair quality of life and affect performance at work and school. This guideline covers the definition and classification of urticaria, taking into account the recent progress in identifying its causes, eliciting factors and pathomechanisms. In addition, it outlines evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria.
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Affiliation(s)
- T. Zuberbier
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Dermatology and Allergy; Allergy-Centre-Charité; Berlin Germany
| | - W. Aberer
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - R. Asero
- Department of Allergology; Clinica San Carlo; Paderno Dugnano MI Italy
| | - A. H. Abdul Latiff
- Allergy& Immunology Centre; Pantai Hospital Kuala Lumpur; Kuala Lumpur Malaysia
| | - D. Baker
- Baker Allergy Asthma and Dermatology Clinic; Portland OR USA
| | - B. Ballmer-Weber
- Allergy Unit; Department of Dermatology; University Hospital; Zürich Switzerland
| | - J. A. Bernstein
- University of Cincinnati Physicians Immunology Research Center; Cincinnati OH USA
| | - C. Bindslev-Jensen
- Department of Dermatology and Allergy Centre; Odense University Hospital and University of Southern Denmark; Odense Denmark
| | - Z. Brzoza
- Department of Internal Diseases, Allergology and Clinical Immunology in Katowice; Medical University of Silesia; Katowice Poland
| | | | - G. W. Canonica
- Personalized Medicine Asthma and Allergy Clinic-Humanitas University & Research Hospital; Milano Italy
| | - M. K. Church
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Dermatology and Allergy; Allergy-Centre-Charité; Berlin Germany
| | - T. Craig
- Department of Medicine and Pediatrics; Penn State University; Hershey Medical Center; Hershey PA USA
| | - I. V. Danilycheva
- National Research Center-Institute of Immunology Federal Medical-Biological Agency of Russia; Moscow Russia
| | - C. Dressler
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Division of Evidence Based Medicine; Department of Dermatology; Berlin Germany
| | - L. F. Ensina
- Federal University of Sao Paulo; Sao Paulo Brazil
| | - A. Giménez-Arnau
- Hospital del Mar; IMIM; Universitat Autònoma Barcelona; Barcelona Spain
| | - K. Godse
- Department of Dermatology; Dr. D. Y. Patil Medical College & Hospital; Nerul Navi Mumbai India
| | - M. Gonçalo
- Clinic of Dermatology; Faculty of Medicine and University Hospital; Coimbra Portugal
| | - C. Grattan
- St John's’ Institute of Dermatology; Guy's’ and St. Thomas’ Hospital; NHS Foundation Trust; London UK
| | - J. Hebert
- Service d'allergie; Centre Hospitalier Université Laval/Centre Hospitalier Universitaire de Québec; Québec QC Canada
| | - M. Hide
- Department of Dermatology; Institute of Biomedical and Health Sciences; Hiroshima University; Hiroshima Japan
| | - A. Kaplan
- Department of Medicine; Division of Pulmonary and Critical Care Medicine; Allergy and Clinical Immunology; Medical University of South Carolina; Charleston SC USA
| | - A. Kapp
- Department of Dermatology and Allergy; Hannover Medical School; Hannover Germany
| | - C. H. Katelaris
- Campbelltown Hospital and Western Sydney University; Sydney Australia
| | - E. Kocatürk
- Department of Dermatology; Okmeydani Training and Research Hospital; Istanbul Turkey
| | - K. Kulthanan
- Department of Dermatology; Faculty of Medicine Siriraj Hospital; Mahidol University; Bangkok Thailand
| | | | | | - M. Magerl
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Dermatology and Allergy; Allergy-Centre-Charité; Berlin Germany
| | - P. Mathelier-Fusade
- Department of Dermatology and Allergy; University Hospital of Tenon; Paris France
| | - R. Y. Meshkova
- Department of Clinical Immunology and Allergy; Smolensk State Medical University; Smolensk Russia
| | - M. Metz
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Dermatology and Allergy; Allergy-Centre-Charité; Berlin Germany
| | - A. Nast
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Division of Evidence Based Medicine; Department of Dermatology; Berlin Germany
| | - E. Nettis
- Scuola e Cattedra di Allergologia e Immunologia Clinica; Dipartimento dell'Emergenza e dei Trapianti d'Organo; Università di Bari; Bari Italy
| | | | - S. Rosumeck
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Division of Evidence Based Medicine; Department of Dermatology; Berlin Germany
| | - S. S. Saini
- Johns Hopkins Asthma and Allergy Center; Baltimore MD USA
| | - M. Sánchez-Borges
- Allergy and Clinical Immunology Department; Centro Médico-Docente La Trinidad; Caracas Venezuela
| | | | - P. Staubach
- Department of Dermatology; University Medical Center Mainz; Mainz Germany
| | - G. Sussman
- Division of Allergy and Clinical Immunology; University of Toronto; Toronto ON Canada
| | - E. Toubi
- Bnai-Zion Medical Center; Faculty of Medicine; Technion Haifa Israel
| | - G. A. Vena
- Dermatology and Venereology Private Practice; Bari and Barletta Italy
| | - C. Vestergaard
- Department of Dermatology and Venereology; Aarhus University Hospital; Aarhus Denmark
| | - B. Wedi
- Department of Dermatology and Allergy; Hannover Medical School; Hannover Germany
| | - R. N. Werner
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Division of Evidence Based Medicine; Department of Dermatology; Berlin Germany
| | - Z. Zhao
- Department of Dermatology and Venereology; Peking University; First Hospital; Beijing China
| | - M. Maurer
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Dermatology and Allergy; Allergy-Centre-Charité; Berlin Germany
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Maurer M, Abuzakouk M, Bérard F, Canonica W, Oude Elberink H, Giménez-Arnau A, Grattan C, Hollis K, Knulst A, Lacour JP, Lynde C, Marsland A, McBride D, Nakonechna A, Ortiz de Frutos J, Proctor C, Sussman G, Sweeney C, Tian H, Weller K, Wolin D, Balp MM. The burden of chronic spontaneous urticaria is substantial: Real-world evidence from ASSURE-CSU. Allergy 2017; 72:2005-2016. [PMID: 28543019 PMCID: PMC5724512 DOI: 10.1111/all.13209] [Citation(s) in RCA: 148] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Chronic spontaneous urticaria (CSU) can be debilitating, difficult to treat, and frustrating for patients and physicians. Real-world evidence for the burden of CSU is limited. The objective of this study was to document disease duration, treatment history, and disease activity, as well as impact on health-related quality of life (HRQoL) and work among patients with inadequately controlled CSU, and to describe its humanistic, societal, and economic burden. METHODS This international observational study assessed a cohort of 673 adult patients with CSU whose symptoms persisted for ≥12 months despite treatment. Demographics, disease characteristics, and healthcare resource use in the previous 12 months were collected from medical records. Patient-reported data on urticaria and angioedema symptoms, HRQoL, and work productivity and activity impairment were collected from a survey and a diary. RESULTS Almost 50% of patients had moderate-to-severe disease activity as reported by Urticaria Activity Score. Mean (SD) Dermatology Life Quality Index and Chronic Urticaria Quality of Life Questionnaire scores were 9.1 (6.62) and 33.6 (20.99), respectively. Chronic spontaneous urticaria markedly interfered with sleep and daily activities. Angioedema in the previous 12 months was reported by 66% of enrolled patients and significantly affected HRQoL. More than 20% of patients reported ≥1 hour per week of missed work; productivity impairment was 27%. These effects increased with increasing disease activity. Significant healthcare resources and costs were incurred to treat CSU. CONCLUSIONS Chronic spontaneous urticaria has considerable humanistic and economic impacts. Patients with greater disease activity and with angioedema experience greater HRQoL impairments.
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Affiliation(s)
- M. Maurer
- Charité - Universitätsmedizin Berlin; Berlin Germany
| | | | - F. Bérard
- Claude Bernard University Lyon; Lyon France
| | - W. Canonica
- IRCCS-Humanitas Research Hospital; Humanitas University; Rozzano-Milano Italy
| | | | | | | | - K. Hollis
- RTI Health Solutions; Research Triangle Park NC USA
| | - A. Knulst
- University Medical Center Utrecht; Utrecht The Netherlands
| | | | - C. Lynde
- Lynderm Research; Toronto ON Canada
| | - A. Marsland
- Salford Royal Hospital; University of Manchester; Salford UK
| | | | - A. Nakonechna
- Royal Liverpool and Broadgreen University Hospitals; Liverpool UK
| | | | - C. Proctor
- RTI Health Solutions; Research Triangle Park NC USA
| | - G. Sussman
- University of Toronto; Toronto ON Canada
| | - C. Sweeney
- RTI Health Solutions; Research Triangle Park NC USA
| | - H. Tian
- Novartis Pharmaceuticals Corporation; East Hanover NJ USA
| | - K. Weller
- Charité - Universitätsmedizin Berlin; Berlin Germany
| | - D. Wolin
- RTI Health Solutions; Research Triangle Park NC USA
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Stull D, McBride D, Tian H, Gimenez Arnau A, Maurer M, Marsland A, Balp MM, Khalil S, Grattan C. Analysis of disease activity categories in chronic spontaneous/idiopathic urticaria. Br J Dermatol 2017; 177:1093-1101. [DOI: 10.1111/bjd.15454] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2017] [Indexed: 11/30/2022]
Affiliation(s)
- D. Stull
- RTI Health Solutions; 200 Park Offices Drive, PO Box 12194 Research Triangle Park NC 27709-2194 U.S.A
| | - D. McBride
- RTI Health Solutions; The Pavilion, Towers Business Park, Wilmslow Road, Didsbury Manchester M20 2LS U.K
| | - H. Tian
- Novartis Pharmaceuticals Corporation; East Hanover NJ U.S.A
| | - A. Gimenez Arnau
- Department of Dermatology; Hospital del Mar and Universitat Autònoma; Barcelona Spain
| | - M. Maurer
- Department of Dermatology and Allergy; Allergie-Centrum-Charité; Charité-Universitätsmedizin Berlin; Berlin Germany
| | - A. Marsland
- Dermatology Department; Salford Royal Hospital and University of Manchester; Manchester U.K
| | - M.-M. Balp
- Novartis Pharma AG; GMA & HEOR; Novartis Campus Basel 4056 Switzerland
| | - S. Khalil
- Novartis Pharma AG; GMA & HEOR; Novartis Campus Basel 4056 Switzerland
| | - C. Grattan
- Cutaneous Allergy; Guy's Hospital; London U.K
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Roberts G, Ollert M, Aalberse R, Austin M, Custovic A, DunnGalvin A, Eigenmann PA, Fassio F, Grattan C, Hellings P, Hourihane J, Knol E, Muraro A, Papadopoulos N, Santos AF, Schnadt S, Tzeli K. A new framework for the interpretation of IgE sensitization tests. Allergy 2016; 71:1540-1551. [PMID: 27224838 DOI: 10.1111/all.12939] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2016] [Indexed: 12/27/2022]
Abstract
IgE sensitization tests, such as skin prick testing and serum-specific IgE, have been used to diagnose IgE-mediated clinical allergy for many years. Their prime drawback is that they detect sensitization which is only loosely related to clinical allergy. Many patients therefore require provocation tests to make a definitive diagnosis; these are often expensive and potentially associated with severe reactions. The likelihood of clinical allergy can be semi-quantified from an IgE sensitization test results. This relationship varies though according to the patients' age, ethnicity, nature of the putative allergic reaction and coexisting clinical diseases such as eczema. The likelihood of clinical allergy can be more precisely estimated from an IgE sensitization test result, by taking into account the patient's presenting features (pretest probability). The presence of each of these patient-specific factors may mean that a patient is more or less likely to have clinical allergy with a given test result (post-test probability). We present two approaches to include pretest probabilities in the interpretation of results. These approaches are currently limited by a lack of data to allow us to derive pretest probabilities for diverse setting, regions and allergens. Also, cofactors, such as exercise, may be necessary for exposure to an allergen to result in an allergic reaction in specific IgE-positive patients. The diagnosis of IgE-mediated allergy is now being aided by the introduction of allergen component testing which may identify clinically relevant sensitization. Other approaches are in development with basophil activation testing being closest to clinical application.
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Affiliation(s)
- G. Roberts
- David Hide Asthma and Allergy Research Centre; St Mary's Hospital; Isle of Wight UK
- NIHR Respiratory Biomedical Research Unit; University Hospital Southampton NHS Foundation Trust; Southampton UK
- Clinical and Experimental Sciences Academic Unit; Faculty of Medicine; University of Southampton; Southampton UK
| | - M. Ollert
- Department of Infection and Immunity; Luxembourg Institute of Health (LIH); Esch-sur-Alzette, Luxembourg and Department of Dermatology and Allergy Center; Odense Research Center for Anaphylaxis; University of Southern Denmark; Odense Denmark
| | - R. Aalberse
- Department of Immunopathology; Sanquin Research; Amsterdam and Landsteiner Laboratory; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | - M. Austin
- Anaphylaxis Campaign; Farnborough UK
| | - A. Custovic
- Department of Paediatrics; Imperial College London; London UK
| | - A. DunnGalvin
- Department of Paediatrics and Child Health; School of Applied Psychology; University College Cork; Cork Ireland
| | - P. A. Eigenmann
- Department of Child and Adolescent; University Hospitals of Geneva; Geneva Switzerland
| | | | - C. Grattan
- Dermatology Centre; Norfolk & Norwich University Hospital; Norwich UK
| | | | - J. Hourihane
- Paediatrics and Child Health; University College Cork; Cork Ireland
| | - E. Knol
- Departments of Immunology and Dermatology/Allergology; University Medical Center Utrecht; Utrecht The Netherlands
| | - A. Muraro
- Department of Pediatrics; University of Padua; Padova Italy
| | - N. Papadopoulos
- Centre for Pediatrics and Child Health; Institute of Human Development; University of Manchester; Manchester UK
- Allergy Department; 2nd Pediatric Clinic; University of Athens; Athens Greece
| | - A. F. Santos
- Division of Asthma, Allergy & Lung Biology; Department of Paediatric Allergy; King's College London; London UK
- MRC & Asthma UK Centre in Allergic Mechanisms of Asthma; London UK
- Immunoallergology Department; Coimbra University Hospital; Coimbra Portugal
| | - S. Schnadt
- German Allergy and Asthma Association (Deutscher Allergie- und Asthmabund (DAAB)); Mönchengladbach Germany
| | - K. Tzeli
- Allergy Department; 2nd Pediatric Clinic; University of Athens; Athens Greece
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9
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Toubi E, Grattan C, Zuberbier T. Diagnostic dilemmas in chronic urticaria. J Eur Acad Dermatol Venereol 2016; 29 Suppl 3:12-5. [PMID: 26053291 DOI: 10.1111/jdv.13197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 04/14/2015] [Indexed: 11/29/2022]
Abstract
The European Academy of Allergy and Clinical Immunology (EAACI)/Global Allergy and Asthma European Network (GA(2) LEN)/European Dermatology Forum (EDF)/World Allergy Organization (WAO) recently published updated recommendations for the classification, diagnosis and management of chronic urticaria (CU). This article discusses several cases of CU that provide examples of how the recommendations in the guidelines can be implemented in the diagnosis of chronic spontaneous urticaria (CSU) (also called chronic idiopathic urticaria [CIU]), chronic inducible urticaria (CINDU) or CU with comorbidities.
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Affiliation(s)
- E Toubi
- Division of Allergy and Clinical Immunology, Bnai-Zion Medical Centre, Haifa, Israel
| | - C Grattan
- Norfolk & Norwich University Hospital and St John's Institute of Dermatology, Norwich, UK
| | - T Zuberbier
- Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité - Universitätsmedizin Berlin, Berlin, Germany
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10
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Giménez-Arnau AM, Grattan C, Zuberbier T, Toubi E. An individualized diagnostic approach based on guidelines for chronic urticaria (CU). J Eur Acad Dermatol Venereol 2016; 29 Suppl 3:3-11. [PMID: 26053290 DOI: 10.1111/jdv.13196] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 04/14/2015] [Indexed: 11/29/2022]
Abstract
Chronic urticaria (CU), defined as the spontaneous or inducible appearance of hives, angioedema or both for 6 weeks or more, presents with a number of subtypes which all substantially impair patients' quality of life (QoL). International urticaria guidelines give clear recommendations on workup and treatment but the occurrence of CU with multiple causes and triggers (sometimes with more than one subtype occurring in a single patient) presents challenges for an individualized assessment by physicians. This review summarizes recent guidance on the classification, diagnosis and assessment of CU subtypes and discusses how currently available patient assessment tools and laboratory tests can be used in clinical practice as part of an individualized patient management plan.
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Affiliation(s)
- A M Giménez-Arnau
- Department of Dermatology, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Grattan
- Norfolk & Norwich University Hospital and St John's Institute of Dermatology, Norwich, UK
| | - T Zuberbier
- Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - E Toubi
- Division of Allergy and Clinical Immunology, Bnai-Zion Medical Centre, Haifa, Israel
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11
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Stull DE, McBride D, Gimenez-Arnau A, Grattan C, Khalil S, Balp MM. Categorical Health States In Chronic Spontaneous Urticaria (Csu) Based On The Weekly Urticaria Activity Score (Uas7): Are They Distinct, Discriminative, And Reproducible? Value Health 2014; 17:A611. [PMID: 27202130 DOI: 10.1016/j.jval.2014.08.2140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- D E Stull
- RTI Health Solutions, Manchester, UK
| | - D McBride
- RTI Health Solutions, Manchester, UK
| | | | - C Grattan
- Norfolk and Norwich University Hospital, Norfolk, UK
| | - S Khalil
- Novartis Pharma AG, Basel, Switzerland
| | - M M Balp
- Novartis Pharma AG, Basel, Switzerland
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12
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Valent P, Escribano L, Broesby-Olsen S, Hartmann K, Grattan C, Brockow K, Niedoszytko M, Nedoszytko B, Oude Elberink JNG, Kristensen T, Butterfield JH, Triggiani M, Alvarez-Twose I, Reiter A, Sperr WR, Sotlar K, Yavuz S, Kluin-Nelemans HC, Hermine O, Radia D, van Doormaal JJ, Gotlib J, Orfao A, Siebenhaar F, Schwartz LB, Castells M, Maurer M, Horny HP, Akin C, Metcalfe DD, Arock M. Proposed diagnostic algorithm for patients with suspected mastocytosis: a proposal of the European Competence Network on Mastocytosis. Allergy 2014; 69:1267-74. [PMID: 24836395 DOI: 10.1111/all.12436] [Citation(s) in RCA: 126] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2014] [Indexed: 01/08/2023]
Abstract
Mastocytosis is an emerging differential diagnosis in patients with more or less specific mediator-related symptoms. In some of these patients, typical skin lesions are found and the diagnosis of mastocytosis can be established. In other cases, however, skin lesions are absent, which represents a diagnostic challenge. In the light of this unmet need, we developed a diagnostic algorithm for patients with suspected mastocytosis. In adult patients with typical lesions of mastocytosis in the skin, a bone marrow (BM) biopsy should be considered, regardless of the basal serum tryptase concentration. In adults without skin lesions who suffer from mediator-related or other typical symptoms, the basal tryptase level is an important parameter. In those with a slightly increased tryptase level, additional investigations, including a sensitive KIT mutation analysis of blood leucocytes or measurement of urinary histamine metabolites, may be helpful. In adult patients in whom (i) KIT D816V is detected and/or (ii) the basal serum tryptase level is clearly increased (>25-30 ng/ml) and/or (iii) other clinical or laboratory features suggest the presence of 'occult' mastocytosis or another haematologic neoplasm, a BM investigation is recommended. In the absence of KIT D816V and other signs or symptoms of mastocytosis or another haematopoietic disease, no BM investigation is required, but the clinical course and tryptase levels are monitored in the follow-up. In paediatric patients, a BM investigation is usually not required, even if the tryptase level is increased. Although validation is required, it can be expected that the algorithm proposed herein will facilitate the management of patients with suspected mastocytosis and help avoid unnecessary referrals and investigations.
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Affiliation(s)
- P. Valent
- Division of Haematology; Department of Internal Medicine I; Medical University of Vienna; Vienna Austria
| | - L. Escribano
- Servicio Central de Citometria; Centro de Investigacion del Cancer (IBMCC; CSIC/USAL); IBSAL and Department of Medicine; University of Salamanca; Salamanca Spain
| | - S. Broesby-Olsen
- Department of Dermatology and Allergy Centre; Odense University Hospital; Odense Denmark
| | - K. Hartmann
- Department of Dermatology; University of Cologne; Cologne Germany
| | - C. Grattan
- Norfolk and Norwich University Hospital; Norwich UK
| | - K. Brockow
- Department of Dermatology and Allergy Biederstein; Technical University of Munich; Munich Germany
| | - M. Niedoszytko
- Department of Allergology; Medical University of Gdansk; Gdansk Poland
| | - B. Nedoszytko
- Department of Dermatology; Medical University of Gdansk; Gdansk Poland
| | - J. N. G. Oude Elberink
- Department of Allergology; University Medical Center of Groningen; University of Groningen; Groningen the Netherlands
| | - T. Kristensen
- Department of Pathology; Odense University Hospital; Odense Denmark
| | | | - M. Triggiani
- Division of Allergy and Clinical Immunology; University of Salerno; Salerno Italy
| | - I. Alvarez-Twose
- Instituto de Estudios de Mastocitosis de Castilla La Mancha (CLMast); Hospital Virgen del Valle; Toledo Spain
| | - A. Reiter
- III. Medizinische Klinik; Universitäts-Medizin Mannheim; Universität Heidelberg; Mannheim Germany
| | - W. R. Sperr
- Division of Haematology; Department of Internal Medicine I; Medical University of Vienna; Vienna Austria
| | - K. Sotlar
- Institute of Pathology; Ludwig-Maximilians-University; Munich Germany
| | - S. Yavuz
- Division of Haematology; Department of Internal Medicine; University of Istanbul; Istanbul Turkey
| | - H. C. Kluin-Nelemans
- Department of Haematology; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
| | - O. Hermine
- Imagine Institute Université Paris Descartes, Sorbonne, Paris Cité; Centre national de référence des mastocytoses; Paris France
| | - D. Radia
- Department of Haematology; Guys and St Thomas' NHS Foundation Trust; Guys Hospital; London UK
| | - J. J. van Doormaal
- Department of Allergology; University Medical Center of Groningen; University of Groningen; Groningen the Netherlands
| | - J. Gotlib
- Stanford Cancer Institute; Stanford University School of Medicine; Stanford CA USA
| | - A. Orfao
- Servicio Central de Citometria; Centro de Investigacion del Cancer (IBMCC; CSIC/USAL); IBSAL and Department of Medicine; University of Salamanca; Salamanca Spain
| | - F. Siebenhaar
- Department of Dermatology & Allergy; Charité Universitätsmedizin Berlin; Berlin Germany
| | - L. B. Schwartz
- Division of Rheumatology, Allergy & Immunology; Department of Internal Medicine; Virginia Common-wealth University; Richmond VA USA
| | - M. Castells
- Division of Allergy and Immunology; Department of Medicine; Brigham and Women's Hospital; Harvard Medical School; Boston MA USA
| | - M. Maurer
- Department of Dermatology & Allergy; Charité Universitätsmedizin Berlin; Berlin Germany
| | - H.-P. Horny
- Institute of Pathology; Ludwig-Maximilians-University; Munich Germany
| | - C. Akin
- Division of Allergy and Immunology; Department of Medicine; Brigham and Women's Hospital; Harvard Medical School; Boston MA USA
| | - D. D. Metcalfe
- Laboratory of Allergic Diseases; NIAID; NIH; Bethesda MD USA
| | - M. Arock
- LBPA CNRS UMR8113; Ecole Normale Supérieure de Cachan; Cachan France
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13
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Rosén K, Maurer M, Hsieh H, Saini S, Grattan C, Gimenéz-Arnau A, Agarwal S, Doyle R, Canvin J, Kaplan A, Casale T. Response to: ‘Omalizumab for the treatment of chronic idiopathic or spontaneous urticaria: a critical appraisal’. Br J Dermatol 2014; 171:15-6. [DOI: 10.1111/bjd.13075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- K. Rosén
- Genentech, Inc.; 1 DNA Way South San Francisco CA 94080 U.S.A
| | - M. Maurer
- Department of Dermatology, and Allergy; Charité-Universitätsmedizin; Berlin Germany
| | - H. Hsieh
- Genentech, Inc.; 1 DNA Way South San Francisco CA 94080 U.S.A
| | - S. Saini
- Johns Hopkins Asthma and Allergy Center; Baltimore MA U.S.A
| | - C. Grattan
- Department of Dermatology; Norfolk and Norwich University Hospital; Norwich U.K
| | - A. Gimenéz-Arnau
- Department of Dermatology; Hospital del Mar; Universitat Autònoma; Barcelona Spain
| | - S. Agarwal
- Genentech, Inc.; 1 DNA Way South San Francisco CA 94080 U.S.A
| | - R. Doyle
- Genentech, Inc.; 1 DNA Way South San Francisco CA 94080 U.S.A
| | - J. Canvin
- Novartis Pharmaceuticals; Horsham West Sussex U.K
| | - A. Kaplan
- Medical University of South Carolina; Charleston SC U.S.A
| | - T. Casale
- University of South Florida; Tampa FL U.S.A
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14
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Grattan C. Night-time sedating H1 antihistamine increases daytime somnolence but not treatment efficacy in chronic spontaneous urticaria: a randomized controlled study. Br J Dermatol 2014; 171:8-9. [DOI: 10.1111/bjd.13112] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- C. Grattan
- Dermatology Centre; Norfolk & Norwich University Hospital; Colney NR4 7UY U.K
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15
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Zuberbier T, Aberer W, Asero R, Bindslev-Jensen C, Brzoza Z, Canonica GW, Church MK, Ensina LF, Giménez-Arnau A, Godse K, Gonçalo M, Grattan C, Hebert J, Hide M, Kaplan A, Kapp A, Abdul Latiff AH, Mathelier-Fusade P, Metz M, Saini SS, Sánchez-Borges M, Schmid-Grendelmeier P, Simons FER, Staubach P, Sussman G, Toubi E, Vena GA, Wedi B, Zhu XJ, Nast A, Maurer M. Methods report on the development of the 2013 revision and update of the EAACI/GA2 LEN/EDF/WAO guideline for the definition, classification, diagnosis, and management of urticaria. Allergy 2014; 69:e1-29. [PMID: 24898678 DOI: 10.1111/all.12370] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2014] [Indexed: 10/25/2022]
Abstract
This methods report describes the process of guideline development in detail. It is the result of a systematic literature review using the 'Grading of Recommendations Assessment, Development and Evaluation' (GRADE) methodology and a structured consensus conference held on 28 and 29 November 2012, in Berlin. It is a joint initiative of the Dermatology Section of the European Academy of Allergy and Clinical Immunology (EAACI), the EU-funded network of excellence, the Global Allergy and Asthma European Network (GA(2) LEN), the European Dermatology Forum (EDF), and the World Allergy Organization (WAO) with the participation of delegates of 21 national and international societies. This guideline covers the definition and classification of urticaria, taking into account the recent progress in identifying its causes, eliciting factors and pathomechanisms. In addition, it outlines evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS) and is published in Allergy 2014; 69:868-887.
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Affiliation(s)
- T. Zuberbier
- Department of Dermatology and Allergy; Allergy-Centre-Charité; Charité - University Hospital Berlin; Berlin Germany
| | - W. Aberer
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - R. Asero
- Allergy Clinic; Clinica San Carlo; Paderno Dugnano Italy
| | - C. Bindslev-Jensen
- Department of Dermatology and ; Allergy Centre; Odense University Hospital and University of Southern Denmark; Odense Denmark
| | - Z. Brzoza
- Department of Internal Diseases, Allergology and Clinical Immunology in Katowice; Medical University of Silesia; Katowice Poland
| | - G. W. Canonica
- Respiratory Diseases & Allergy; University of Genoa; IRCCS AOU SanMartino; Genoa Italy
| | - M. K. Church
- Department of Dermatology and Allergy; Allergy-Centre-Charité; Charité - University Hospital Berlin; Berlin Germany
| | - L. F. Ensina
- Federal University of Sao Paulo; Sao Paulo Brazil
| | - A. Giménez-Arnau
- Hospital del Mar. Parc de Salut Mar; Universitat Autònoma; Barcelona Spain
| | - K. Godse
- Department of Dermatology; Dr. D. Y. Patil Medical College & Hospital; Nerul Navi Mumbai India
| | - M. Gonçalo
- Clinic of Dermatology; Faculty of Medicine and University Hospital; Coimbra Portugal
| | - C. Grattan
- St John's' Institute of Dermatology; Guy's' and St Thomas' Hospitals NHS Foundation Trust; London UK
| | - J. Hebert
- Center for Applied Research on Allergy Québec; Québec QC Canada
| | - M. Hide
- Department of Dermatology; Institute of Biomedical and Health Sciences; Hiroshima University; Hiroshima Japan
| | - A. Kaplan
- Division of Pulmonary and Critical Care Medicine, Allergy and Clinical Immunology; Department of Medicine; Medical University of South Carolina; Charleston SC USA
| | - A. Kapp
- Department of Dermatology and Allergy; Hannover Medical School; Hannover Germany
| | - A. H. Abdul Latiff
- Department of Paediatrics; Pantai Hospital Kuala Lumpur; Bangsar Malaysia
| | - P. Mathelier-Fusade
- Department of Dermatology and Allergy; University Hospital of Tenon; Paris France
| | - M. Metz
- Department of Dermatology and Allergy; Allergy-Centre-Charité; Charité - University Hospital Berlin; Berlin Germany
| | - S. S. Saini
- Johns Hopkins Asthma and Allergy Center; Baltimore MD USA
| | - M. Sánchez-Borges
- Allergy and Clinical Immunology Department; Centro Médico-Docente La Trinidad; Caracas Venezuela
| | | | - F. E. R. Simons
- Department of Pediatrics & Child Health; University of Manitoba; Winnipeg MB Canada
- Department of Immunology; University of Manitoba; Winnipeg MB Canada
| | - P. Staubach
- Department of Dermatology; University Medical Center Mainz; Mainz Germany
| | - G. Sussman
- Division of Allergy and Clinical Immunology; University of Toronto; Toronto ON Canada
| | - E. Toubi
- Bnai-Zion Medical Center; Faculty of Medicine; Technion; Haifa Israel
| | - G. A. Vena
- Unit of Dermatology and Venereology; Department of Biomedical Sciences and Human Oncology; University of Bari; Bari Italy
| | - B. Wedi
- Department of Dermatology and Allergy; Hannover Medical School; Hannover Germany
| | - X. J. Zhu
- Department of Dermatology; Peking University First Hospital; Beijing China
| | - A. Nast
- Department of Dermatology and Allergy; Allergy-Centre-Charité; Charité - University Hospital Berlin; Berlin Germany
| | - M. Maurer
- Department of Dermatology and Allergy; Allergy-Centre-Charité; Charité - University Hospital Berlin; Berlin Germany
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16
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Zuberbier T, Aberer W, Asero R, Bindslev-Jensen C, Brzoza Z, Canonica GW, Church MK, Ensina LF, Giménez-Arnau A, Godse K, Gonçalo M, Grattan C, Hebert J, Hide M, Kaplan A, Kapp A, Abdul Latiff AH, Mathelier-Fusade P, Metz M, Nast A, Saini SS, Sánchez-Borges M, Schmid-Grendelmeier P, Simons FER, Staubach P, Sussman G, Toubi E, Vena GA, Wedi B, Zhu XJ, Maurer M. The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update. Allergy 2014; 69:868-87. [PMID: 24785199 DOI: 10.1111/all.12313] [Citation(s) in RCA: 666] [Impact Index Per Article: 66.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2013] [Indexed: 12/13/2022]
Abstract
This guideline is the result of a systematic literature review using the 'Grading of Recommendations Assessment, Development and Evaluation' (GRADE) methodology and a structured consensus conference held on 28 and 29 November 2012, in Berlin. It is a joint initiative of the Dermatology Section of the European Academy of Allergy and Clinical Immunology (EAACI), the EU-funded network of excellence, the Global Allergy and Asthma European Network (GA(2) LEN), the European Dermatology Forum (EDF), and the World Allergy Organization (WAO) with the participation of delegates of 21 national and international societies. Urticaria is a frequent, mast cell-driven disease, presenting with wheals, angioedema, or both. The life-time prevalence for acute urticaria is approximately 20%. Chronic spontaneous urticaria and other chronic forms of urticaria do not only cause a decrease in quality of life, but also affect performance at work and school and, as such, are members of the group of severe allergic diseases. This guideline covers the definition and classification of urticaria, taking into account the recent progress in identifying its causes, eliciting factors and pathomechanisms. In addition, it outlines evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS).
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Affiliation(s)
- T. Zuberbier
- Department of Dermatology and Allergy; Allergy-Centre-Charité; Charité - University Hospital Berlin; Berlin Germany
| | - W. Aberer
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - R. Asero
- Allergy Clinic; Clinica San Carlo; Paderno Dugnano MI Italy
| | - C. Bindslev-Jensen
- Department of Dermatology and Allergy Centre; Odense University Hospital; University of Southern Denmark; Odense Denmark
| | - Z. Brzoza
- Department of Internal Diseases, Allergology and Clinical Immunology in Katowice; Medical University of Silesia; Zabrze Poland
| | - G. W. Canonica
- Respiratory Diseases & Allergy; University of Genoa; IRCCS AOU SanMartino; Genoa Italy
| | - M. K. Church
- Department of Dermatology and Allergy; Allergy-Centre-Charité; Charité - University Hospital Berlin; Berlin Germany
| | - L. F. Ensina
- Department of Clinical Immunology and Allergy; Federal University of Sao Paulo; Sao Paulo Brazil
| | - A. Giménez-Arnau
- Hospital del Mar. Parc de Salut Mar; Universitat Autònoma Barcelona; Barcelona Spain
| | - K. Godse
- Department of Dermatology; Dr. D. Y. Patil Medical College & Hospital; Nerul Navi Mumbai India
| | - M. Gonçalo
- Clinic of Dermatology; Faculty of Medicine and University Hospital; Coimbra Portugal
| | - C. Grattan
- St John's Institute of Dermatology; Guy's and St Thomas' Hospitals NHS Foundation Trust; London UK
| | - J. Hebert
- Center for Applied Research on Allergy Québec; Québec QC Canada
| | - M. Hide
- Department of Dermatology; Institute of Biomedical and Health Sciences; Hiroshima University; Hiroshima Japan
| | - A. Kaplan
- Division of Pulmonary and Critical Care Medicine, Allergy and Clinical Immunology; Department of Medicine; Medical University of South Carolina; Charleston SC USA
| | - A. Kapp
- Department of Dermatology and Allergy; Hannover Medical School; Hannover Germany
| | - A. H. Abdul Latiff
- Department of Paediatrics; Pantai Hospital Kuala Lumpur; Bangsar Kuala Lumpur Malaysia
| | - P. Mathelier-Fusade
- Department of Dermatology and Allergy; University Hospital of Tenon; Paris France
| | - M. Metz
- Department of Dermatology and Allergy; Allergy-Centre-Charité; Charité - University Hospital Berlin; Berlin Germany
| | - A. Nast
- Department of Dermatology and Allergy; Allergy-Centre-Charité; Charité - University Hospital Berlin; Berlin Germany
| | - S. S. Saini
- Johns Hopkins Asthma and Allergy Center; Baltimore MD USA
| | - M. Sánchez-Borges
- Allergy and Clinical Immunology Department Centro Médico-Docente La Trinidad; Caracas Venezuela
| | | | - F. E. R. Simons
- Departments of Pediatrics & Child Health, Immunology; University of Manitoba; Winnipeg MB Canada
| | - P. Staubach
- Department of Dermatology; University Medical Center Mainz; Mainz Germany
| | - G. Sussman
- Division of Allergy and Clinical Immunology; University of Toronto; Toronto ON Canada
| | - E. Toubi
- Bnai-Zion Medical Center; Faculty of Medicine; Technion; Haifa Israel
| | - G. A. Vena
- Unit of Dermatology and Venereology; Department of Biomedical Sciences and Human Oncology; University of Bari; Bari Italy
| | - B. Wedi
- Department of Dermatology and Allergy; Hannover Medical School; Hannover Germany
| | - X. J. Zhu
- Department of Dermatology; Peking University First Hospital; Beijing China
| | - M. Maurer
- Department of Dermatology and Allergy; Allergy-Centre-Charité; Charité - University Hospital Berlin; Berlin Germany
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17
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Ortonne JP, Viguier M, Casale T, Maurer M, Hsieh HJ, Canvin J, Saini S, Grattan C, Giménez-Arnau A, Kaplan A, Rosén K. Efficacité et tolérance de l’omalizumab dans l’urticaire chronique spontanée (UCS) : résultats d’une étude de phase 3, randomisée, en double-insu, versus placebo. Ann Dermatol Venereol 2013. [DOI: 10.1016/j.annder.2013.09.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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18
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Simon A, Asli B, Braun-Falco M, De Koning H, Fermand JP, Grattan C, Krause K, Lachmann H, Lenormand C, Martinez-Taboada V, Maurer M, Peters M, Rizzi R, Rongioletti F, Ruzicka T, Schnitzler L, Schubert B, Sibilia J, Lipsker D. Schnitzler's syndrome: diagnosis, treatment, and follow-up. Allergy 2013; 68:562-8. [PMID: 23480774 DOI: 10.1111/all.12129] [Citation(s) in RCA: 164] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2013] [Indexed: 01/03/2023]
Abstract
Schnitzler's syndrome is characterized by recurrent urticarial rash and monoclonal gammopathy, associated with clinical and biological signs of inflammation and a long-term risk of AA amyloidosis and overt lymphoproliferation. An extensive literature review was performed, and the following questions were addressed during an expert meeting: In whom should Schnitzler's syndrome be suspected? How should the diagnosis of Schnitzler's syndrome be established? How should a patient with Schnitzler's syndrome be treated? How should a patient with Schnitzler's syndrome be followed up?. A diagnosis of Schnitzler's syndrome is considered definite in any patient with two obligate criteria: a recurrent urticarial rash and a monoclonal IgM gammopathy, and two of the following minor criteria: recurrent fever, objective signs of abnormal bone remodeling, elevated CRP level or leukocytosis, and a neutrophilic infiltrate on skin biopsy. It is considered probable, if only 1 minor criterion is present. In patients with monoclonal IgG gammopathies, diagnosis is definite if three minor criteria are present and possible if two are present. First-line treatment in patients with significant alteration of quality of life or persistent elevation of markers of inflammation should be anakinra. Follow-up should include clinical evaluation, CBC and CRP every 3 months and MGUS as usually recommended.
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Affiliation(s)
- A. Simon
- Department of General Internal Medicine/Infectious Diseases; Radboud University Nijmegen Medical Centre; Nijmegen; the Netherlands
| | - B. Asli
- Unité d'Immuno-Hématologie; Hôpital Saint-Louis; AP-HP and Univ Paris Diderot; Paris; France
| | - M. Braun-Falco
- Department of Dermatology and Allergology; Ludwig-Maximilians University; Munich; Germany
| | - H. De Koning
- Department of Dermatology; Radboud University Nijmegen Medical Centre; Nijmegen; the Netherlands
| | - J.-P. Fermand
- Unité d'Immuno-Hématologie; Hôpital Saint-Louis; AP-HP and Univ Paris Diderot; Paris; France
| | - C. Grattan
- Norfolk and Norwich University Hospital; Norwich; UK
| | - K. Krause
- Department of Dermatology and Allergy; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | - H. Lachmann
- Division of Medicine; National Amyloidosis Centre; University College London Medical School; London; UK
| | - C. Lenormand
- Faculté de Médecine; Université de Strasbourg, and Clinique Dermatologique; Hôpitaux Universitaires de Strasbourg; Strasbourg; France
| | - V. Martinez-Taboada
- Servicio de Reumatologia; Hospital Universitario Marqués de Valdecilla; Santander; Spain
| | - M. Maurer
- Department of Dermatology and Allergy; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | - M. Peters
- Departments of Dermatology and Laboratory Medicine and Pathology; Mayo Clinic; Rochester; MN; USA
| | - R. Rizzi
- Department of Haematology; University of Bari Medical School; Bari
| | - F. Rongioletti
- Department of Dermatology; University of Genova; Genova; Italy
| | - T. Ruzicka
- Department of Dermatology and Allergology; Ludwig-Maximilians University; Munich; Germany
| | | | | | - J. Sibilia
- Faculté de Médecine; Université de Strasbourg, and Service de Rhumatologie; Hôpitaux Universitaires de Strasbourg; Strasbourg; France
| | - D. Lipsker
- Faculté de Médecine; Université de Strasbourg, and Clinique Dermatologique; Hôpitaux Universitaires de Strasbourg; Strasbourg; France
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Baiardini I, Braido F, Bindslev-Jensen C, Bousquet PJ, Brzoza Z, Canonica GW, Compalati E, Fiocchi A, Fokkens W, Gerth van Wijk R, Giménez-Arnau A, Godse K, Grattan C, Grob JJ, La Grutta S, Kalogeromitros D, Kocatürk E, Lombardi C, Mota-Pinto A, Ridolo E, Saini SS, Sanchez-Borges M, Senna GE, Terreehorst I, Todo Bom A, Toubi E, Bousquet J, Zuberbier T, Maurer M. Recommendations for assessing patient-reported outcomes and health-related quality of life in patients with urticaria: a GA(2) LEN taskforce position paper. Allergy 2011; 66:840-4. [PMID: 21385184 DOI: 10.1111/j.1398-9995.2011.02580.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this Global Allergy and Asthma European Network (GA(2)LEN) consensus report is to provide recommendations and suggestions for assessing patient-reported outcomes (PROs) including health-related quality of life in patients with urticaria. We recommend that PROs should be used both in clinical trials and routine practice for the evaluation of urticaria patients. We suggest that PROs should be considered as the primary outcome of future clinical trials. Two validated and disease-specific instruments for assessing PROs are available, the urticaria activity score (for symptoms) and the chronic urticaria questionnaire on quality of life CU-Q(2)oL. This latter tool, CU-Q(2)oL, is available in many languages and should be preferred, where available, over more generic instruments for assessing urticaria-specific effects on quality of life. CU-Q(2)oL is only suited for the investigation of patients with chronic spontaneous urticaria. Similar instruments for other forms of urticaria have yet to be developed and validated. Also, tools for assessing other chronic spontaneous urticaria PROs besides quality of life and symptoms are needed.
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Affiliation(s)
- I Baiardini
- Allergy and Respiratory Diseases, Department of Internal Medicine, University of Genoa, Genoa, Italy
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Almqvist C, Bradding PB, Chakir J, Ebo D, Grattan C, Kariyawasam HH, Savilahti E, Scadding GK, Vieths S, Wardlaw AJ, Woodfolk J. Developments in the field of allergy in 2008 through the eyes of Clinical & Experimental Allergy. Clin Exp Allergy 2010; 39:1482-98. [PMID: 19954428 DOI: 10.1111/j.1365-2222.2009.03355.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
In 2008, many thousands of articles were published on the subject of allergic disease with over 200 reviews, editorials and original papers in Clinical & Experimental Allergy alone. These represent a considerable amount of data and even the most avid reader could only hope to assimilate a small fraction of this knowledge. There is therefore a pressing need for the key messages that emerge from a journal such as Clinical & Experimental Allergy to be summarized by experts in the field in a form that highlights the significance of the developments and sets them in the context of important findings in the field published in other journals. This also has the advantage of making connections between new data in conditions such as asthma, where articles often appear in different sections of the journal. As can be seen from this review, the body of work is diverse both in terms of the disease of interest and the discipline that has been used to investigate it. However, taken as a whole, we hope that the reader will gain a flavour of where the field is mature, where there remain controversies and where the cutting edge is leading.
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Gompels MM, Lock RJ, Abinun M, Bethune CA, Davies G, Grattan C, Fay AC, Longhurst HJ, Morrison L, Price A, Price M, Watters D. C1 inhibitor deficiency: consensus document. Clin Exp Immunol 2005; 139:379-94. [PMID: 15730382 PMCID: PMC1809312 DOI: 10.1111/j.1365-2249.2005.02726.x] [Citation(s) in RCA: 323] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
We present a consensus document on the diagnosis and management of C1 inhibitor deficiency, a syndrome characterized clinically by recurrent episodes of angio-oedema. In hereditary angio-oedema, a rare autosomal dominant condition, C1 inhibitor function is reduced due to impaired transcription or production of non-functional protein. The diagnosis is confirmed by the presence of a low serum C4 and absent or greatly reduced C1 inhibitor level or function. The condition can cause fatal laryngeal oedema and features indistinguishable from gastrointestinal tract obstruction. Attacks can be precipitated by trauma, infection and other stimulants. Treatment is graded according to response and the clinical site of swelling. Acute treatment for severe attack is by infusion of C1 inhibitor concentrate and for minor attack attenuated androgens and/or tranexamic acid. Prophylactic treatment is by attenuated androgens and/or tranexamic acid. There are a number of new products in trial, including genetically engineered C1 esterase inhibitor, kallikrein inhibitor and bradykinin B2 receptor antagonist. Individual sections provide special advice with respect to diagnosis, management (prophylaxis and emergency care), special situations (childhood, pregnancy, contraception, travel and dental care) and service specification.
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Affiliation(s)
- M M Gompels
- Department of Immunology and Immunogenetics, North Bristol NHS Trust, Southmead Hospital, Bristol, UK.
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Abstract
These guidelines for management of urticaria and angio-oedema have been prepared for dermatologists on behalf of the British Association of Dermatologists. They present evidence-based guidance for treatment, with identification of the strength of evidence available at the time of preparation of the guidelines, and a brief overview of aetiology, diagnosis and investigation.
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Affiliation(s)
- C Grattan
- Department of Dermatology, West Norwich Hospital, Norwich, UK
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Grattan C, Burton JL, Manku M, Stewart C, Horrobin DF. Essential-fatty-acid metabolites in plasma phospholipids in patients with ichthyosis vulgaris, acne vulgaris and psoriasis. Clin Exp Dermatol 1990; 15:174-6. [PMID: 2142029 DOI: 10.1111/j.1365-2230.1990.tb02066.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The concentration of essential fatty acids (EFAs) and their metabolites in plasma phospholipids were measured by gas chromatography in normal individuals, and in patients with ichthyosis vulgaris, acne vulgaris or psoriasis. In all three patient groups, concentrations of arachidonic acid (20:4 omega 6) and docosapentaenoic acid (22:5 omega 6) were significantly below those in controls, suggesting that these abnormalities may occur in many skin diseases. Concentrations of dihomogammalinolenic acid (20:3 omega 6) were low in ichthyosis, normal in acne and elevated in psoriasis. Thus ichthyosis, acne and psoriasis each had a characteristic pattern of EFA metabolites.
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Affiliation(s)
- C Grattan
- Department of Dermatology, General Hospital, Birmingham, UK
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