Atualização do Guia Prático da Associação Brasileira de Alergia e Imunologia para o Diagnóstico e Tratamento da Urticária baseado na diretriz internacional
An update on the Brazilian Association of Allergy and Immunology Practical Guide for the Diagnosis and Management of Urticaria based on the international guideline
Gabriela Andrade Coelho Dias; Rosana Câmara Agondi; Larissa Silva Brandão; Eli Mansour; Priscilla Filippo A. M. Santos; Fernanda Lugão Campinhos; Paula Natassya Argolo; Bruna Gehlen; Rozana de Fátima Gonçalves; Leila Vieira Borges Trancoso-Neves; Janaína Michele Lima Melo; Eduardo Souza Lima; Luis Felipe Chiaverini Ensina; Solange Oliveira Rodrigues Valle; Régis de Albuquerque Campos
Resumo
A urticária é uma condição caracterizada pela presença de urticas, angioedema, ou ambos, que pode ser classificada de acordo com o tempo de duração em aguda, quando persiste por menos de 6 semanas, ou crônica, quando por mais de 6 semanas e afeta significativamente a qualidade de vida. A atualização das recomendações quanto ao seu diagnóstico e tratamento é elaborada por especialistas de todo o mundo, que se reúnem a cada quatro anos em Berlim para revisar todas as novas evidências que justifiquem modificações na diretriz internacional. Este artigo discute as principais recomendações propostas na versão atual da diretriz internacional.
Palavras-chave
Abstract
Urticaria is a condition characterized by the presence of hives, angioedema, or both. It can be classified according to its duration as acute, when it persists for less than 6 weeks, or chronic, when it persists for more than 6 weeks and greatly affects quality of life. Updated recommendations on diagnosis and management are developed by experts from all over the world who meet every 4 years in Berlin and review all new evidence that supports changes to the international guideline. This paper discusses the main recommendations proposed in the current version of the international guideline.
Keywords
References
1. Zuberbier T, Abdul Latiff AH, Abuzakouk M, Aquilina S, Asero R, Baker D, et al. The international EAACI/GA2LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy. 2022;77:734-66.
2. Ensina LF, Valle SOR, Campos RA, Agondi R, Criado P, Bedrikow RB, et al. Guia prático da Associação Brasileira de Alergia e Imunologia para o diagnóstico e tratamento das urticárias baseado em diretrizes internacionais. Arq Asma Alerg Imunol. 2019;3(4):382-92. doi:10.5935/2526-5393.20190052.
3. Kolkhir P, Giménez-Arnau AM, Kulthanan K, Peter J, Metz M, Maurer M. Urticaria. Nat Rev Dis Primer. 2022;8:61.
4. Balp M-M, Lopes Da Silva N, Vietri J, Tian H, Ensina LF. The Burden of Chronic Urticaria from Brazilian Patients' Perspective. Dermatol Ther. 2017;7:535-45.
5. Andrade Coelho Dias G, Cunha Coelho F, Filippo P, Lacerda Pedrazzi D, Nogueira Arraes AC, Perello MI, et al. Clinical experience of a chronic urticaria referral university center. Eur Ann Allergy Clin Immunol. 2020;52:74.
6. De Souza ACMCFF, Dortas Junior SD, Azizi GG, França AT, Lupi O, Valle SOR. Chronic urticaria: profile from a reference center. An Bras Dermatol. 2022;97:511-12.
7. Borriello F, Iannone R, Marone G. Histamine Release from Mast Cells and Basophils. In: Hattori Y, Seifert R (eds). Histamine and Histamine Receptors in Health and Disease. Springer International Publishing: Cham, 2017. p. 12139.
8. Asero R, Ferrer M, Kocaturk E, Maurer M. Chronic Spontaneous Urticaria: The Role and Relevance of Autoreactivity, Autoimmunity, and Autoallergy. J Allergy Clin Immunol Pract. 2023;11:23028.
9. Sabroe RA. Acute urticaria. Immunol Allergy Clin North Am. 2014;34:11-21.
10. Solé D, Ivancevich JC, Borges MS, Coelho MA, Rosário NA, Ardusso LRF, et al. Anaphylaxis in Latin America: a report of the online Latin American survey on anaphylaxis (OLASA). Clinics. 2011;66:943-7.
11. Jares EJ, Sánchez-Borges M, Cardona-Villa R, Ensina LF, Arias-Cruz A, Gómez M, et al. Multinational experience with hypersensitivity drug reactions in Latin America. Ann Allergy Asthma Immunol. 2014;113:282-9.
12. Modena B, White AA, Woessner KM. Aspirin and Nonsteroidal Antiinflammatory Drugs Hypersensitivity and Management. Immunol Allergy Clin North Am. 2017;37:727-49.
13. Rutnin N, Kulthanan K, Tuchinda P, Jongjarearnprasert K. Drug-induced urticaria: causes and clinical courses. J Drugs Dermatol JDD. 2011;10:1019-24.
14. Fok JS, Kolkhir P, Church MK, Maurer M. Predictors of treatment response in chronic spontaneous urticaria. Allergy. 2021;76:296581.
15. Metz M, Altrichter S, Buttgereit T, Fluhr JW, Fok JS, Hawro T, et al. The Diagnostic Workup in Chronic Spontaneous Urticaria-What to Test and Why. J Allergy Clin Immunol Pract, 2021;9:2274-83.
16. Kaplan A, Lebwohl M, Giménez-Arnau AM, Hide M, Armstrong AW, Maurer M. Chronic spontaneous urticaria: Focus on pathophysiology to unlock treatment advances. Allergy. 2023;78:389-401.
17. Kolkhir P, Muñoz M, Asero R, Ferrer M, Kocatürk E, Metz M, et al. Autoimmune chronic spontaneous urticaria. J Allergy Clin Immunol. 2022;149:1819-31.
18. Schoepke N, Asero R, Ellrich A, Ferrer M, Gimenez-Arnau A, EH Grattan C, et al. Biomarkers and clinical characteristics of autoimmune chronic spontaneous urticaria: Results of the PURIST Study. Allergy. 2019;74:2427-36.
19. Metz M, Altrichter S, Buttgereit T, Fluhr JW, Fok JS, Hawro T, et al. The Diagnostic Workup in Chronic Spontaneous Urticaria - What to Test and Why. J Allergy Clin Immunol Pract. 2021;9:227483.
20. Sánchez J, Sánchez A, Cardona R. Prevalence of Drugs as Triggers of Exacerbations in Chronic Urticaria. J Investig Allergol Clin Immunol. 2019;29:112-7.
21. Bansal CJ, Bansal AS. Stress, pseudoallergens, autoimmunity, infection and inflammation in chronic spontaneous urticaria. Allergy Asthma Clin Immunol. 2019;15:56.
22. Sánchez J, Sánchez A, Cardona R. Dietary Habits in Patients with Chronic Spontaneous Urticaria: Evaluation of Food as Trigger of Symptoms Exacerbation. Dermatol Res Pract. 2018;2018: 6703052.
23. Magerl M, Altrichter S, Borzova E, Giménez-Arnau A, Grattan CEH, Lawlor F, et al. The definition, diagnostic testing, and management of chronic inducible urticarias - The EAACI/GA(2) LEN/EDF/UNEV consensus recommendations 2016 update and revision. Allergy. 2016;71:780-2.
24. Fukunaga A, Washio K, Hatakeyama M, Oda Y, Ogura K, Horikawa T, et al. Cholinergic urticaria: epidemiology, physiopathology, new categorization, and management. Clin Auton Res. 2018 Feb;28(1):103-13.
25. Fok JS, Katelaris CH. Urticaria and mimickers of urticaria. Front Allergy. 2023;4:1274031.
26. Bernstein JA, Ziaie N, Criado R, Criado PR, Rea S, Davis M. Chronic Urticaria and Angioedema: Masqueraders and Misdiagnoses. J Allergy Clin Immunol Pract. 2023;11:225163.
27. Davis MDP, Van Der Hilst JCH. Mimickers of Urticaria: Urticarial Vasculitis and Autoinflammatory Diseases. J Allergy Clin Immunol Pract. 2018;6:1162-70.
28. Sekerel BE, Ilgun Gurel D, Sahiner UM, Soyer O, Kocaturk E. The many faces of pediatric urticaria. Front Allergy. 2023;4:1267663.
29. Baiardini I, Braido F, Bindslev-Jensen C, Bousquet PJ, Brzoza Z, Canonica GW, et al. 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;66:8404.
30. Valle SOR, Dortas-Junior SD, Dias GAC, Motta AA, do-Amaral CSF, Martins EAPR, et al. Ferramentas para avaliação e acompanhamento da urticária crônica. Arq Asma Alerg Imunol. 2018;2(2):209-24. doi:10.5935/2526-5393.20180021.
31. Moestrup K, Ghazanfar MN, Thomsen SF. Patient-reported outcomes (PROs) in chronic urticaria. Int J Dermatol. 2017;56:1342-48.
32. Weller K, Siebenhaar F, Hawro T, Altrichter S, Schoepke N, Maurer M. Clinical Measures of Chronic Urticaria. Immunol Allergy Clin North Am. 2017;37:35-49.
33. Stull D, McBride D, Tian H, Gimenez Arnau A, Maurer M, Marsland A, et al. Analysis of disease activity categories in chronic spontaneous/idiopathic urticaria. Br J Dermatol. 2017;177:1093-101.
34. Dias GAC, Pires GV, Valle SOR, França AT, Papi JA, Dortas SD, et al. Cross-cultural adaptation of the Brazilian-Portuguese version of the chronic urticaria quality-of-life questionnaire - CU-Q2oL. Allergy. 2011;66:1487-93.
35. Dortas Junior SD, Valle SOR, Weller K, Maurer M, Lupi O. Validity, reliability, and interpretability of the Brazilian urticaria control test. Allergy Asthma Proc. 2020;41:e61-e66.
36. de-Aquino BM, Lacerda AE, Marcelino FC, da-Silva BG, Nunes ICC, Solé D, et al. Tradução e adaptação transcultural para o idioma português (Brasil) do instrumento 'Angioedema Activity Score'. Arq Asma Alerg Imunol. 2018;2(3):351-6. doi:10.5935/2526-5393.20180042.
37. Weller K, Groffik A, Magerl M, Tohme N, Martus P, Krause K, et al. Development and construct validation of the angioedema quality of life questionnaire. Allergy. 2012;67:1289-98.
38. Weller K, Donoso T, Magerl M, Aygören-Pürsün E, Staubach P, Martinez-Saguer I, et al. Validation of the Angioedema Control Test (AECT) - A Patient-Reported Outcome Instrument for Assessing Angioedema Control. J Allergy Clin Immunol Pract. 2020;8:2050-2057.e4.
39. Weller K, Groffik A, Church MK, Hawro T, Krause K, Metz M, et al. Development and validation of the Urticaria Control Test: A patient-reported outcome instrument for assessing urticaria control. J Allergy Clin Immunol. 2014;133:1365-1372.e6.
40. Baiardini I, Pasquali M, Braido F, Fumagalli F, Guerra L, Compalati E et al. A new tool to evaluate the impact of chronic urticaria on quality of life: chronic urticaria quality of life questionnaire (CU-QoL). Allergy. 2005;60:1073-78.
41. Weller K, Groffik A, Magerl M, Tohme N, Martus P, Krause K, et al. Development, validation, and initial results of the Angioedema Activity Score. Allergy. 2013;68:1185-92.
42. Weller K, Zuberbier T, Maurer M. Chronic urticaria: tools to aid the diagnosis and assessment of disease status in daily practice. J Eur Acad Dermatol Venereol JEADV. 2015;29(Suppl 3):38-44.
43. Kubo N, Senda M, Ohsumi Y, Sakamoto S, Matsumoto K, Tashiro M, et al. Brain histamine H1 receptor occupancy of loratadine measured by positron emission topography: comparison of H1 receptor occupancy and proportional impairment ratio: H1 RECEPTOR OCCUPANCY OF LORATADINE. Hum Psychopharmacol Clin Exp. 2011;26:133-9.
44. Sharma M, Bennett C, Cohen SN, Carter B. H1-antihistamines for chronic spontaneous urticaria. Cochrane Database Syst Rev. 2014 Nov 14;2014(11):CD006137.
45. Lippert U, Möller A, Welker P, Artuc M, Henz BM. Inhibition of cytokine secretion from human leukemic mast cells and basophils by H1- and H2-receptor antagonists. Exp Dermatol. 2000;9:11824.
46. Church MK, Maurer M, Simons FER, Bindslev-Jensen C, van Cauwenberge P, Bousquet J, et al. Risk of first-generation H(1)-antihistamines: a GA(2)LEN position paper. Allergy. 2010;65:45966.
47. Maurer M, Zuberbier T, Metz M. The Classification, Pathogenesis, Diagnostic Workup, and Management of Urticaria: An Update. In: Traidl-Hoffmann C, Zuberbier T, Werfel T (eds). Allergic Diseases - From Basic Mechanisms to Comprehensive Management and Prevention. Springer International Publishing: Cham; 2021. p. 11733.
48. Guillén-Aguinaga S, Jáuregui Presa I, Aguinaga-Ontoso E, Guillén-Grima F, Ferrer M. Updosing nonsedating antihistamines in patients with chronic spontaneous urticaria: a systematic review and meta-analysis. Br J Dermatol. 2016;175:1153-65.
49. Zuberbier T. Pharmacological rationale for the treatment of chronic urticaria with second-generation non-sedating antihistamines at higher-than-standard doses. J Eur Acad Dermatol Venereol JEADV. 2012;26:9-18.
50. Giménez Arnau AM, Valero Santiago A, Bartra Tomás J, Jáuregui Presa I, Labrador Horrillo M, Miquel Miquel FJ, et al. Therapeutic Strategy According to Differences in Response to Omalizumab in Patients With Chronic Spontaneous Urticaria. J Investig Allergol Clin Immunol. 2019;29:338-48.
51. Easthope S, Jarvis B. Omalizumab: Drugs. 2001;61:253-60.
52. Kaplan AP, Giménez-Arnau AM, Saini SS. Mechanisms of action that contribute to efficacy of omalizumab in chronic spontaneous urticaria. Allergy. 2017;72:519-33.
53. Agache I, Akdis CA, Akdis M, Brockow K, Chivato T, Del Giacco S, et al. EAACI Biologicals Guidelines - Omalizumab for the treatment of chronic spontaneous urticaria in adults and in the paediatric population 12-17 years old. Allergy. 2022;77:17-38.
54. Türk M, Carneiro-Leão L, Kolkhir P, Bonnekoh H, Buttgereit T, Maurer M. How to Treat Patients with Chronic Spontaneous Urticaria with Omalizumab: Questions and Answers. J Allergy Clin Immunol Pract. 2020;8:113-24.
55. Ferrer M, Boccon-Gibod I, Gonçalo M, Inalöz HS, Knulst A, Lapeere H et al. Expert opinion: defining response to omalizumab in patients with chronic spontaneous urticaria. Eur J Dermatol. 2017;27:45563.
56. Saini SS, Bindslev-Jensen C, Maurer M, Grob J-J, Bülbül Baskan E, Bradley MS, et al. Efficacy and Safety of Omalizumab in Patients with Chronic Idiopathic/Spontaneous Urticaria Who Remain Symptomatic on H 1 Antihistamines: A Randomized, Placebo-Controlled Study. J Invest Dermatol. 2015;135:67-75.
57. Giménez-Arnau AM. Omalizumab for treating chronic spontaneous urticaria: an expert review on efficacy and safety. Expert Opin Biol Ther. 2017;17:375-85.
58. Omalizumab [Internet]. DrugBank. Disponível em: https://www.drugbank.ca/drugs/DB00043. Acessado em: 06/02/2024.
59. Xolair: EPAR-Product Information [Internet]. Última atualização: 21/12/2023. Disponível em: https://www.ema.europa.eu//en/documents/product-information/xolair-epar-product-information_en.pdf. Acessado em: 06/02/2024.
60. Maurer M, Metz M, Brehler R, Hillen U, Jakob T, Mahler V, et al. Omalizumab treatment in patients with chronic inducible urticaria: A systematic review of published evidence. J Allergy Clin Immunol. 2018;141:638-49.
61. McSweeney SM, Christou EAA, Maurer M, Grattan CE, Tziotzios C, McGrath JA. Physical urticaria: Clinical features, pathogenesis, diagnostic work-up, and management. J Am Acad Dermatol. 2023;89:324-37.
62. Chang J, Cattelan L, Ben-Shoshan M, Le M, Netchiporouk E. Management of Pediatric Chronic Spontaneous Urticaria: A Review of Current Evidence and Guidelines. J Asthma Allergy. 2021;14:18799.
63. Khan DA. Alternative agents in refractory chronic urticaria: evidence and considerations on their selection and use. J Allergy Clin Immunol Pract. 2013;1:433-440.e1.
64. Kessel A, Toubi E. Cyclosporine - A in severe chronic urticaria: the option for long-term therapy. Allergy. 2010;65:1478-82.
65. Savic S, Marsland A, McKay D, Ardern-Jones MR, Leslie T, Somenzi O, et al. Retrospective case note review of chronic spontaneous urticaria outcomes and adverse effects in patients treated with omalizumab or ciclosporin in UK secondary care. Allergy Asthma Clin Immunol. 2015 Jul 21;11(1):21.
66. Kocatürk E, Baskan EB, Küçük ÖS, Özdemir M, Örnek S, Can PK et al. Omalizumab versus cyclosporin-A for the treatment of chronic spontaneous urticaria: can we define better-responding endotypes? An Bras Dermatol. 2022;97:592-600.
67. Vena GA, Maurer M, Cassano N, Zuberbier T. Alternative treatments for chronic spontaneous urticaria beyond the guideline algorithm. Curr Opin Allergy Clin Immunol. 2017;17:278-85.
68. Cain DW, Cidlowski JA. Immune regulation by glucocorticoids. Nat Rev Immunol. 2017;17:233-47.
69. Levin ER, Hammes SR. Nuclear receptors outside the nucleus: extranuclear signalling by steroid receptors. Nat Rev Mol Cell Biol. 2016;17:783-97.
70. Alcântara CTD, Raeder DFT, Campinhos FL, Brandão LS, Campos RDA, Franca AT, et al. Practical guide to acute urticaria. Arq Asma Alerg Imunol. 2022;6:214-24.
71. Palungwachira P, Vilaisri K, Musikatavorn K, Wongpiyabovorn J. A randomized controlled trial of adding intravenous corticosteroids to H1 antihistamines in patients with acute urticaria. Am J Emerg Med. 2021;42:192-7.
72. Doumen M, Pazmino S, Bertrand D, Westhovens R, Verschueren P. Glucocorticoids in rheumatoid arthritis: Balancing benefits and harm by leveraging the therapeutic window of opportunity. Joint Bone Spine. 2023;90:105491.
73. Kocaturk E, Saini SS, Rubeiz CJ, Bernstein JA. Existing and Investigational Medications for Refractory Chronic Spontaneous Urticaria: Safety, Adverse Effects, and Monitoring. J Allergy Clin Immunol Pract. 2022;10:3099-116.
74. Yosipovitch G, Biazus Soares G, Mahmoud O. Current and Emerging Therapies for Chronic Spontaneous Urticaria: A Narrative Review. Dermatol Ther. 2023;13:1647-60.
75. Gabrielli S, Le M, Netchiporouk E, Miedzybrodzki B, Baum S, Greenberger S, et al. Chronic urticaria in children can be controlled effectively with updosing second-generation antihistamines. J Am Acad Dermatol. 2020;82:1535-7.
76. Ensina LF, Bastos PGA, de Lacerda AE, de Araujo CA, Camelo-Nunes I, Solé D. Comments on Balp et al. Pediatr Allergy Immunol. 2018 Sep;29(6):669-70.
77. Balp MM, Weller K, Carboni V, Chirilov A, Papavassilis C, Severin T, et al. Reply to Ensina et al. Pediatr Allergy Immunol. 2018 Sep;29(6):670-1.
78. Hide M, Suzuki T, Tanaka A, Aoki H. Efficacy and safety of rupatadine in Japanese adult and adolescent patients with chronic spontaneous urticaria: A double-blind, randomized, multicenter, placebo-controlled clinical trial. Allergol Int. 2019 Jan;68(1):59-67.
79. Gimenez-Arnau A, Pujol RM, Ianosi S, Kaszuba A, Malbran A, Poop G, et al. Rupatadine in the treatment of chronic idiopathic urticaria: a double-blind, randomized, placebo-controlled multicentre study. Allergy. 2007;62:539-46.
80. Nelson HS, Reynolds R, Mason J. Fexofenadine HCl is safe and effective for treatment of chronic idiopathic urticaria. Ann Allergy Asthma Immunol. 2000 May;84(5):517-22.
81. Consultas: Bulário Eletrônico ANVISA - Agência Nacional de Vigilância Sanitária. [Internet]. Disponível em: https://consultas.anvisa.gov.br/#/bulario/. Acessado em: 02/09/2023.
82. Al-Shaikhly T, Rosenthal JA, Ayars AG, Petroni DH. Omalizumab for chronic urticaria in children younger than 12 years. Ann Allergy Asthma Immunol. 2019 Aug;123(2):208-10.
83. Corral-Magaña O, Gil-Sánchez JA, Bover-Bauzá C, Martinez-Cepas P, Montis-Palos MC, Martín-Santiago A. Chronic urticaria in children under 15 years of age: Clinical experience beyond the clinical trials. Pediatr Dermatol. 2021;38:385-9.
84. Song X-T, Chen Y-D, Yu M, Liu B, Zhao Z-T, Maurer M. Omalizumab in children and adolescents with chronic urticaria: A 16-week real-world study. Allergy. 2021;76:1271-3.
85. Briand C, Tetart F, Soria A, Staumont-Sallé D, Sterling B, Boralevi F, et al. Omalizumab in cold urticaria in children: Retrospective case series of 13 patients, review of the literature. Ann Dermatol Venereol. 2021;148: 269-71.
86. Japiassu LG, Bastos PGA, Araújo CA, Camelo-Nunes IC, Solé D, Ensina LF. Omalizumabe no tratamento da urticária crônica espontânea em pacientes pediátricos. Arq Asma Alerg Imunol. 2018;2:s78.
87. Neverman L, Weinberger M. Treatment of chronic urticaria in children with antihistamines and cyclosporine. J Allergy Clin Immunol Pract. 2014;2:434-8.
88. Boubouka CD, Charissi C, Kouimintzis D, Kalogeromitros D, Stavropoulos PG, Katsarou A. Treatment of autoimmune urticaria with low-dose cyclosporin A: A one-year follow-up. Acta Derm Venereol. 2011;91:50-4.
89. Kulthanan K, Chaweekulrat P, Komoltri C, Hunnangkul S, Tuchinda P, Chularojanamontri L, et al. Cyclosporine for Chronic Spontaneous Urticaria: A Meta-Analysis and Systematic Review. J Allergy Clin Immunol Pract. 2018;6:586-99.
90. Staubach P, Peveling-Oberhag A, Lang BM, Zimmer S, Sohn A, Mann C. Severe chronic spontaneous urticaria in children - treatment options according to the guidelines and beyond - a 10 years review. J Dermatol Treat. 2022;33:1119-22.
91. Caffarelli C, Paravati F, El Hachem M, Duse M, Bergamini M, Simeone G, et al. Management of chronic urticaria in children: a clinical guideline. Ital J Pediatr. 2019;45:101.
92. Kolkhir P, Metz M, Altrichter S, Maurer M. Comorbidity of chronic spontaneous urticaria and autoimmune thyroid diseases: A systematic review. Allergy. 2017;72:1440-60.
93. Kocatürk E, Podder I, Zenclussen AC, Kasperska Zajac A, Elieh-Ali-Komi D, Church MK, et al. Urticaria in Pregnancy and Lactation. Front Allergy. 2022;3:892673.
94. Liao S-L, Yu M, Zhao Z-T, Maurer M. Case Report: Omalizumab for Chronic Spontaneous Urticaria in Pregnancy. Front Immunol. 2021;12:652973.
95. Podder I, Dhabal A, Chakraborty SS. Efficacy and Safety of Up-dosed Second-generation Antihistamines in Uncontrolled Chronic Spontaneous Urticaria: A Review. J Clin Aesthetic Dermatol. 2023;16:44-50.
96. Kocatürk E, Al-Ahmad M, Krause K, Gimenez-Arnau AM, Thomsen SF, Conlon N, et al. Treatment patterns and outcomes in patients with chronic urticaria during pregnancy: Results of PREG-CU, a UCARE study. J Eur Acad Dermatol Venereol. 2023;37:356-64.
97. Vieira dos Santos R, Locks Bidese B, Rabello de Souza J, Maurer M. Effects of omalizumab in a patient with three types of chronic urticaria. Br J Dermatol. 2014;170:469-71.
98. Ensina L, Cusato-Ensina A, Camelo-Nunes I, Solé D. Omalizumab as Third-Line Therapy for Urticaria During Pregnancy. J Investig Allergol Clin Immunol. 2017;27:326-7.
99. Saito J, Yakuwa N, Sandaiji N, Uno C, Yagishita S, Suzuki T, et al. Omalizumab concentrations in pregnancy and lactation: A case study. J Allergy Clin Immunol Pract. 2020;8:3603-4.
100. Kulthanan K, Rujitharanawong C, Munprom K, Trakanwittayarak S, Phumariyapong P, Prasertsook S, et al. Prevalence, Clinical Manifestations, Treatment, and Clinical Course of Chronic Urticaria in Elderly: A Systematic Review. J Asthma Allergy. 2022;15:145590.
101. Khaliliya R, Confino-Cohen R, Lachover-Roth I, Meir-Shafrir K, Cohen-Engler A, Rosman Y. Chronic Urticaria in Elderly-New Insights. J Allergy Clin Immunol Pract. 2023;11:1290-4.
102. Patruno C, Fabbrocini G, Cillo F, Torta G, Stingeni L, Napolitano M. Chronic Urticaria in Older Adults: Treatment Considerations. Drugs Aging. 2023;40:165-77.
103. Nettis E, Cegolon L, Di Leo E, Canonica WG, Detoraki A, Baiardini I, et al. Omalizumab in elderly patients with chronic spontaneous urticaria: An Italian real-life experience. Ann Allergy Asthma Immunol. 2018;120:318-23.
104. Cho Y-T, Chan TC, Lee C-H, Chou W-Y, Hsiao P-F, Chen Y-J, et al. Taiwanese dermatological association consensus for the definition, classification, diagnosis, and management of urticaria: A 2021 update. J Formos Med Assoc Taiwan Yi Zhi. 2022;121:1191203.
105. Oztop N, Demir S, Unal D, Beyaz S, Terzioglu K, Olgac M, et al. Predictive factors of recurrence after omalizumab cessation in the elderly with urticaria: A real-life study. Allergy Asthma Proc. 2022;43:519-28.
Submitted date:
05/05/2024
Accepted date:
06/10/2024
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