SummaryBackgroundCholinergic urticaria (CholU) is a frequent type of chronic inducible urticaria. Symptomatic treatment with second‐generation antihistamines (sgAH) is recommended by current guidelines as first‐line therapy, but little is known about how patients with CholU are treated in real life and how they respond to treatment.AimTo assess real‐life treatment of CholU in German‐speaking countries.MethodsPatients with CholU (n = 111) took part in an online survey study that assessed their treatments and their treatment responses.ResultsVirtually all patients (97 %) had used antihistamines, 87 % of them sgAH; 23 % had also taken first‐generation antihistamines (fgAH). The proportion of patients who benefited from standard‐dosed antihistamine treatment was low (sgAH: 32 % vs. fgAH: 16 %), and side effects of sgAH and fgAH were comparable. Updosing of antihistamines had been tried by 66 patients (59 %) (most commonly [98 %, n = 65] with sgAH) and resulted in marginally better responses (sgAH: 38 % vs. fgAH: 32 %). Only very few patients had used other treatments, mostly corticosteroids (30 %) and omalizumab (5 %).ConclusionsSgAH were commonly used, but insufficient in about two thirds of CholU patients. Accordingly, improved use of third‐line and fourth‐line treatment options and development of better therapies for patients with CholU are needed.
ZusammenfassungHintergrundDie cholinergische Urtikaria (CholU) ist eine häufige Unterform der chronischen induzierbaren Urtikaria. Die aktuellen Leitlinien empfehlen eine symptomatische Therapie mit Antihistaminika (AH) der zweiten Generation (sgAH, second‐generation antihistamines) als Therapie der ersten Wahl. Allerdings ist wenig darüber bekannt, welche Therapien CholU‐Patienten im klinischen Alltag tatsächlich erhalten und wie sie auf diese ansprechen.ZielUntersuchung der Therapie der CholU in deutschsprachigen Ländern unter Alltagsbedingungen.MethodenPatienten mit CholU (n = 111) nahmen an einer Online‐Befragung teil und gaben Auskunft über die eingesetzten Therapieformen und das Ansprechen.ErgebnissePraktisch alle Patienten (97 %) hatten bereits Antihistaminika eingenommen, davon 87 % sgAH, 23 % auch Antihistaminika der ersten Generation (fgAH). Der Anteil der Patienten, die von einer AH‐Therapie in Standarddosierung profitierten, war niedrig (sgAH: 32 % vs. fgAH: 16 %); die Nebenwirkungen unter sgAH und fgAH waren vergleichbar. 66 Patienten (59 %) hatten es bereits mit einem Updosing der AH (meist sgAH [98 %, n = 65]) versucht und das Ansprechen darunter war marginal besser (sgAH: 38 % vs. fgAH: 32 %). Nur sehr wenige Patienten hatten andere Behandlungsoptionen ausprobiert, zumeist Glukokortikosteroide (30 %) und Omalizumab (5 %).SchlussfolgerungensgAH wurden häufig eingesetzt, erwiesen sich aber bei etwa zwei Dritteln der CholU‐Patienten als nicht ausreichend wirksam. Entsprechend sollten die Therapieoptionen der dritten und vierten Linie effektiver genutzt werden. Auch ist die Entwicklung von besseren Therapieoptionen für Patienten mit CholU erforderlich.
BackgroundCholinergic urticaria (CholU) is a common type of chronic inducible urticaria. Little is known about the burden of the disease and its unmet medical needs.AimTo characterize the unmet medical needs of patients with CholU.MethodsPatients with CholU (n = 111) took part in a German online survey that assessed their symptoms, diagnostic delay, impact on daily life, quality of life (QoL), and their experience with physician care.ResultsVirtually all patients reported typical signs and symptoms of CholU, i.e., whealing (93.7%) and itching (91.9%), in response to typical trigger situations, such as physical activity, passive warming, or stress. Despite this, patients reported a marked diagnostic delay of 30.2 months (range from 0 to 279 months). Only 38% of the patients received a blood examination, and only 16% underwent provocation testing for diagnosing CholU, as recommended by the international guidelines. Physician contacts were common, but patient satisfaction with their disease management was low. In total, 90.1% of the patients stated to have an uncontrolled disease, resulting in a strong impact on their everyday activities, sleep, and QoL.ConclusionPatients with CholU exhibit many important unmet needs, and improvement in the diagnostic workup and patient care is needed, as are better treatment options.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.