Recommendations on the use of systemic treatments for urticaria and atopic dermatitis during the COVID-19 pandemic: Statement of Dermatoallergy Working Group of the Turkish Society of Dermatology

Salman, Andaç; Alper, Sibel; Atakan, Nilgün; Başkan, Emel Bülbül; Borlu, Murat; Canpolat, Filiz; Erdem, Teoman; Erdem, Yasemin; Gül, Ülker; Kartal, Selda Pelin; Koca, Rafet; Küçük, Özlem Su; Öğretmen, Zerrin; Özkaya, Esen; Sarıcaoğlu, Hayriye; Şavk, Ekin; Taşkapan, Oktay; Utaş, Serap; Kocatürk, Emek

doi:10.4274/turkderm.galenos.2020.80000

Cited by 4 publications

(20 citation statements)

References 18 publications

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“…Also, the initiation of antihistamine and omalizumab treatment has not changed at most UCAREs during the pandemic (96.8% and 77.4%, respectively). This is in line with current recommendations for urticaria and other mast cell‐driven diseases 10,11,27,28 . With respect to the implementation of international guidelines during the pandemic, the first three lines of treatments, that is, a standard‐dose antihistamine, an updosed antihistamine, and omalizumab, should be continued to be used as recommended.…”

Section: Discussionsupporting

confidence: 73%

The global impact of the COVID‐19 pandemic on the management and course of chronic urticaria

Kocatürk

Salman

Chérrez-Ojeda

et al. 2020

Allergy

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Introduction The COVID‐19 pandemic dramatically disrupts health care around the globe. The impact of the pandemic on chronic urticaria (CU) and its management are largely unknown. Aim To understand how CU patients are affected by the COVID‐19 pandemic; how specialists alter CU patient management; and the course of CU in patients with COVID‐19. Materials and Methods Our cross‐sectional, international, questionnaire‐based, multicenter UCARE COVID‐CU study assessed the impact of the pandemic on patient consultations, remote treatment, changes in medications, and clinical consequences. Results The COVID‐19 pandemic severely impairs CU patient care, with less than 50% of the weekly numbers of patients treated as compared to before the pandemic. Reduced patient referrals and clinic hours were the major reasons. Almost half of responding UCARE physicians were involved in COVID‐19 patient care, which negatively impacted on the care of urticaria patients. The rate of face‐to‐face consultations decreased by 62%, from 90% to less than half, whereas the rate of remote consultations increased by more than 600%, from one in 10 to more than two thirds. Cyclosporine and systemic corticosteroids, but not antihistamines or omalizumab, are used less during the pandemic. CU does not affect the course of COVID‐19, but COVID‐19 results in CU exacerbation in one of three patients, with higher rates in patients with severe COVID‐19. Conclusions The COVID‐19 pandemic brings major changes and challenges for CU patients and their physicians. The long‐term consequences of these changes, especially the increased use of remote consultations, require careful evaluation.

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Section: Discussionsupporting

confidence: 73%

The global impact of the COVID‐19 pandemic on the management and course of chronic urticaria

Kocatürk

Salman

Chérrez-Ojeda

et al. 2020

Allergy

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“…Indeed, it was reported that omalizumab significantly reduced seasonal viral respiratory infections in children with asthma 28 . In light of these data, discontinuation of omalizumab was not recommended in patients who were already using this drug at the time when the pandemic started 8 …”

Section: Discussionmentioning

confidence: 99%

“…Omalizumab, as a novel treatment option, is known to be an effective and safe agent in the treatment of moderate to severe CU that is Recently, it was recommended by study groups to continue omalizumab as home treatment during the pandemic. 8,9 The main concern on the administration of omalizumab at home is the risk of anaphylaxis, however, this risk was reported to be very low (0.1%) in asthma bronchiale patients who received omalizumab. 16 On the other hand, CU patients receiving omalizumab treatment, were not reported to have anaphylaxis in the pivotal study, and only several suspicious cases of anaphylaxis were reported.…”

Section: T a B L E 1 The Demographic And Clinical Findings Of Patientmentioning

confidence: 99%

“…22,23 There is limited evidence on the safety of the immunomodulatory, immunosuppressive drugs, and biologics used in the treatment of skin diseases during the COVID-19 pandemic. Several reports and guidelines were published on treatment, management, and follow-up of skin diseases during the COVID-19 pandemic, 24,25 including urticaria [5][6][7][8][9] with special concern on this issue. General recommendations were that patients should be made aware of the social distancing, and hand hygiene, 5,8 and of the necessity of lessening the face-to-face visits, and postponing appointments unless there are emergency situations, as well as the preference of teledermatology or phone triage rather than face-to-face visits.…”

Section: T a B L E 1 The Demographic And Clinical Findings Of Patientmentioning

confidence: 99%

“…Several reports and guidelines were published on treatment, management, and follow-up of skin diseases during the COVID-19 pandemic, 24,25 including urticaria [5][6][7][8][9] with special concern on this issue. General recommendations were that patients should be made aware of the social distancing, and hand hygiene, 5,8 and of the necessity of lessening the face-to-face visits, and postponing appointments unless there are emergency situations, as well as the preference of teledermatology or phone triage rather than face-to-face visits. 5,6,8 Further recommendations included avoidance of the triggering factors and learning of the stress coping methods.…”

Section: T a B L E 1 The Demographic And Clinical Findings Of Patientmentioning

confidence: 99%

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The impact of COVID ‐19 pandemic on the management of patients with chronic urticaria: An observational two‐center study from Turkey

Erdem

Ekinci

Altunay

et al. 2020

Dermatologic Therapy

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The Coronavirus Disease 2019 (COVID‐19) outbreak significantly affected the clinical practice in hospitals and the management of many diseases. The aim of this study was to evaluate the effect of pandemic‐related factors on the severity and course of chronic urticaria (CU). A total of 194 CU patients who were on regular follow‐up, were enrolled in the study. The disease activity was assessed by means of the weekly urticaria activity score (UAS7) and urticaria control test (UCT). Patients were divided into two subgroups according to their disease aggravation as “aggravated” and “non‐aggravated”. Two groups were compared in terms of demographic, clinical, COVID‐19‐associated parameters, and parameters related with the effect of COVID‐19 pandemic on CU management. The omalizumab use was statistically higher (P = .017), and the systemic corticosteroid use was statistically lower (P = .025) in the “aggravated” group. Adherence to quarantine was significantly lower in the “aggravated” group (P = .027). 173 patients (89.2%) were unable to contact a dermatologist during the pandemic. Among 186 patients who received treatment for CU before the pandemic, 48 (25.8%) did not continue the existing treatment during the pandemic. CU aggravated in one patient with COVID‐19 and remained stable in the other. This study showed that CU patients, especially those on omalizumab therapy, had difficulties in attending medical care and even in the maintenance of their existing therapies during the pandemic. Creating novel follow‐up and treatment models as well as the increased use of teledermatology might be beneficial in the management of this life‐disturbing condition.

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Retrospective evaluation of patients with chronic spontaneous urticaria using omalizumab during the COVID‐19 pandemic

Yıldırım

Öğüt

Erbağcı

2022

J of Cosmetic Dermatology

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Omalizumab (OMZ) is a recombinant, humanized, and monoclonal immunoglobulin G1 (IgG1) anti-IgE antibody approved in patients 12 years of age and older with chronic spontaneous urticaria (CSU) resistant to H1 antihistamines. OMZ blocks IgE binding to its high-affinity FCεRI, resulting in a reduction in free IgE and IgE-mediated reactions. 1 The data on the use of OMZ during the coronavirus disease 19 (COVID-19) pandemic are limited, and our current knowledge is mainly based on case reports. It is recommended to continue OMZ in patients with mild-to-moderate COVID-19, and to prolong the dose intervals or interrupt the treatment according to the patient-based risk-benefit analysis in case of severe disease. 2,3 The aim of this study was to evaluate 1) the prevalence of COVID-19 infection, 2) maintenance of omalizumab treatment, 3) vaccination status, and 4) exacerbation of urticaria symptoms related to COVID-19 infection or vaccination in patients with CSU using omalizumab during the pandemic.

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Recommendations on the use of systemic treatments for urticaria and atopic dermatitis during the COVID-19 pandemic: Statement of Dermatoallergy Working Group of the Turkish Society of Dermatology

Cited by 4 publications

References 18 publications

The global impact of the COVID‐19 pandemic on the management and course of chronic urticaria

The global impact of the COVID‐19 pandemic on the management and course of chronic urticaria

The impact of COVID ‐19 pandemic on the management of patients with chronic urticaria: An observational two‐center study from Turkey

Retrospective evaluation of patients with chronic spontaneous urticaria using omalizumab during the COVID‐19 pandemic

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