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The Pan African Medical Journal 2023
PubMed: 37159631
DOI: 10.11604/pamj.2023.44.76.36864 -
Journal of Korean Medical Science Jul 2022Omalizumab is a very important drug for the treatment of chronic urticaria. Although omalizumab's therapeutic efficacy has been demonstrated, data on real-world...
BACKGROUND
Omalizumab is a very important drug for the treatment of chronic urticaria. Although omalizumab's therapeutic efficacy has been demonstrated, data on real-world experiences in Korea, especially regarding chronic inducible urticaria (CIndU), are limited. This study attempted to compare the efficacy of omalizumab in Korean chronic spontaneous urticaria (CSU) and CIndU patients.
METHODS
Fifty-two CSU and 29 CIndU patients were included and Urticaria Activity Score 7 (UAS7) at baseline, week 4, and week 12 was assessed retrospectively.
RESULTS
Omalizumab 150 mg significantly decreased UAS7 in both patients with CSU and CIndU with only one dose ( < 0.001). The significant decrease in the UAS7 scores of both groups of patients continued from weeks 4 to 12. Although there was no significant difference in treatment efficacy between the two groups, the symptoms of patients with CSU tended to improve faster; furthermore, the number of antihistamines administered daily reduced more significantly in this patient group ( = 0.047). Additionally, the decrease in the UAS7 score between baseline and week 12 and the response rate were higher in patients with CSU.
CONCLUSION
Omalizumab may be slightly more effective against CSU than against CIndU. Regarding the CIndU subtypes, dermatographic urticaria was associated with the greatest reduction in the UAS7 score, and patients with this condition showed the highest response rate, indicating the best effect of omalizumab. The duration of chronic urticaria was greater in non-responders than in responders ( = 0.025). Conversely, baseline immunoglobulin E levels were significantly higher in responders ( = 0.039).
Topics: Anti-Allergic Agents; Chronic Disease; Chronic Urticaria; Humans; Omalizumab; Retrospective Studies; Treatment Outcome; Urticaria
PubMed: 35818702
DOI: 10.3346/jkms.2022.37.e211 -
Cureus Jul 2022The urgent requirement for a preventative vaccination became more pressing due to the severe repercussions that the SARS-CoV-2 (COVID-19) virus had on society and the...
The urgent requirement for a preventative vaccination became more pressing due to the severe repercussions that the SARS-CoV-2 (COVID-19) virus had on society and the economy. The deployment of the COVID-19 vaccination program had to be expedited. As with all vaccinations, adverse events have been recorded with the COVID-19 vaccine. Some patients may experience cutaneous reactions such as rashes, itching, hives, and swelling after receiving the COVID-19 vaccine, but it is unclear how common these events are or how frequently they recur. This article discusses an unusual case of a young man who got chronic severe dermatographism after receiving a booster shot of the Moderna vaccine (Moderna, Inc., Cambridge, Massachusetts).
PubMed: 35936173
DOI: 10.7759/cureus.26566 -
Journal of Immunology Research 2022Chronic urticaria (CU) is comprised of diverse phenotypes, and thus, a shift towards a precision medical approach is warranted in its management.
BACKGROUND
Chronic urticaria (CU) is comprised of diverse phenotypes, and thus, a shift towards a precision medical approach is warranted in its management.
METHODS
This study enrolled 78 patients with CU. Serum erythrocyte sedimentation rate, hemoglobin, hematocrit, eosinophil count, IgE, antinuclear antibody (ANA), and serum diamine oxidase (DAO) levels of the patients were measured and were compared according to the patient's response to second-generation antihistamines (sgAH), corticosteroids, leukotriene receptor antagonist (LTRA), H blockers, and low-histamine diet.
RESULTS
Age- and sex-adjusted logistic regression analysis showed that patients with duration of CU > 3 years (adjusted odd ratio [aOR] = 4.39) and a DAO level < 10 U/mL (aOR = 3.90) were significantly associated with a good sgAH response. Age > 50 years (aOR = 0.02), duration of chronic urticaria > 3 years (aOR =0.06), and an ANA titer ≥ 1 : 80 (aOR = 0.03) were significantly and inversely associated with corticosteroid response. A low-histamine diet response was significantly associated with LTRA response (aOR = 67.29). In addition, a DAO level < 5.4 U/mL (aOR = 71.95) was significantly associated with H blocker response. Furthermore, concomitant angioedema (aOR = 10.56), multiple food triggers (aOR = 11.69), and a DAO level < 5.4 U/mL (aOR = 3.78) were significantly associated with a low-histamine diet response. Conversely, dermatographic urticaria and a hematocrit level < 36% were significantly and inversely associated with low-histamine diet response.
CONCLUSIONS
Several promising biomarkers were identified in this study to predict the efficacy of chronic urticaria treatment. DAO could be a novel biomarker for predicting the efficacy not only of dietary intervention but also for antagonists of H and H receptors.
Topics: Chronic Disease; Chronic Urticaria; Diet; Histamine; Humans; Urticaria
PubMed: 35242884
DOI: 10.1155/2022/5243825 -
The Journal of Allergy and Clinical... 2014Physical urticaria is a subtype of chronic urticaria induced by a physical stimulus.
BACKGROUND
Physical urticaria is a subtype of chronic urticaria induced by a physical stimulus.
OBJECTIVE
To evaluate the consistency between a history of physical urticaria and results of challenge testing.
METHODS
Seventy-six subjects, ages 3 to 77 years old, were referred with the diagnosis of a physical urticaria and were evaluated by using challenge testing directed toward the presenting diagnosis, yet included other stimuli based on history. The majority of subjects were tested to 3 or more stimuli, thus 294 provocation tests were performed. Fifty-seven subjects were surveyed for the status of their physical urticaria at least 1 year after initial evaluation.
RESULTS
Of the 76 subjects with a positive history of a physical urticaria, 38% (n = 29) were challenge negative to the presenting diagnosis. Eight subjects within the challenge negative group reacted positively to additional testing, thus 28% (n = 21) remained negative to all challenge testing, which allowed discontinuation of medications and avoidance behavior. A negative challenge result was less likely with subjects who presented with cold-induced urticaria (25%), delayed pressure urticaria (25%), and dermatographism (29%), yet more common with cholinergic (65%) and solar urticaria (67%). A 1-year follow-up survey of 57 subjects was consistent with initial results. Nineteen of this subgroup were rechallenged for the presenting diagnosis, and the outcome was unchanged in 17 subjects and, in 2 subjects the urticaria had resolved.
CONCLUSIONS
The diagnosis by history of a physical urticaria should be verified by testing whenever possible and particularly if the condition is judged as severe and thus requires both significant life-style changes and pharmacologic intervention.
Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Chronic Disease; Cold Temperature; Exercise Test; Female; Humans; Male; Middle Aged; Photic Stimulation; Physical Stimulation; Predictive Value of Tests; Pressure; Prognosis; Risk Factors; Risk Reduction Behavior; Severity of Illness Index; Time Factors; Ultraviolet Rays; Urticaria; Young Adult
PubMed: 25439372
DOI: 10.1016/j.jaip.2014.07.008 -
Indian Dermatology Online Journal 2015About 25-45% of patients of chronic urticaria (CU) have been stated to have histamine releasing autoantibodies in their blood. The term autoimmune urticaria is...
BACKGROUND
About 25-45% of patients of chronic urticaria (CU) have been stated to have histamine releasing autoantibodies in their blood. The term autoimmune urticaria is increasingly being accepted for this subgroup of patients. Review of the literature suggests high autologous serum skin test (ASST) positivity and presence of antithyroid microsomal antibodies in patients with autoimmune urticaria.
AIMS
To study prevalence of ASST positivity and antithyroid microsomal antibodies in chronic "idiopathic" urticaria and to study the correlation between the two parameters.
METHODS
All patients of chronic idiopathic urticaria satisfying inclusion/exclusion criteria were enrolled in the study after written informed consent. Patients of CU secondary to infections and infestations, physical urticaria including dermatographism, mastocytosis, urticarial vasculitis and those on treatment with immunosuppressive drugs for urticaria were excluded from the study. In all of these patients, complete blood count; ASST, serum T3/T4/thyroid stimulating hormone levels, antithyroid microsomal antibody (AMA) levels were done. Statistical analysis was done by Chi-square test, Fisher exact test and Kappa statistics.
RESULTS
Study included 24 males and 26 females with mean age of 39.54 years. Majority of patients belonged to 20-40 years of age. Females showed more ASST positivity. A total of 12 out of 50 (24%) patients showed positive ASST. A total of four out of 12 (33.33%) had positive ASST and raised AMA levels.
CONCLUSION
Only 25% of patients of chronic idiopathic urticaria had positive ASST. ASST and AMA levels were positively correlated in our study. Further studies are required to authenticate this association.
PubMed: 26225328
DOI: 10.4103/2229-5178.160255 -
Postgraduate Medical Journal Jun 2021
Topics: Adult; COVID-19; Female; Histamine Antagonists; Humans; N95 Respirators; SARS-CoV-2; Urticaria
PubMed: 32913035
DOI: 10.1136/postgradmedj-2020-138688 -
The Journal of Allergy and Clinical... 2015Identifying clinical characteristics of patients with chronic urticaria (CU) responsive to medication may help guide clinicians select treatment.
BACKGROUND
Identifying clinical characteristics of patients with chronic urticaria (CU) responsive to medication may help guide clinicians select treatment.
OBJECTIVE
The objective of this study was to investigate patient characteristics and medication use associated with urticaria control.
METHODS
A retrospective longitudinal chart review of adult patients with CU was conducted at a multisite allergy practice. Inclusion criteria required at least 4 CU office visits to allow for pre- and posttreatment assessment. Control corresponding to medication(s) used was assessed each visit. Univariate analysis followed by multiple logistic regression was performed.
RESULTS
A total of 221 patients with CU were included; 140 (63%) achieved complete control. The average time to control was 1.4 ± 2.7 years, which required 1-3 classes of medications. Dermatographia odds ratio (OR) = 1.85 (95% CI 1.3-2.7) or other physical urticarias, OR = 1.51 (1-2.4) and neutrophilic infiltrates on skin biopsy were markers of poor control. Thyroid autoantibodies were associated with better control using an H1-antihistamine. Whereas 22% were controlled on a second-generation H1-receptor antagonist plus a leukotriene receptor antagonist (LTRA), an additional 33% were controlled when cyclosporine was added. Use of a first or second H1-antagonist or LTRA was associated with a 3.5-16.9 times higher odds of complete CU control in those with dermatographia. The odds of achieving control for other forms of physical urticaria was greatest when colchicine was added (aOR = 32.6 [12.7-83.2]).
CONCLUSIONS
Patient-specific CU characteristics associated with medication-disease control may be useful for selecting treatment regimens. A subset of CU patients remains poorly controlled that indicates an unmet need for novel therapeutic agents.
Topics: Adult; Anti-Allergic Agents; Biopsy; Chi-Square Distribution; Chronic Disease; Drug Therapy, Combination; Female; Histamine H1 Antagonists; Histamine H2 Antagonists; Humans; Immunologic Tests; Leukotriene Antagonists; Logistic Models; Longitudinal Studies; Male; Medical Records; Middle Aged; Multivariate Analysis; Odds Ratio; Ohio; Predictive Value of Tests; Retrospective Studies; Risk Factors; Time Factors; Treatment Outcome; Urticaria
PubMed: 25680926
DOI: 10.1016/j.jaip.2014.12.007