Revisions to the international guidelines on the diagnosis and therapy of chronic urticaria
Revisions to the international guidelines on the diagnosis and therapy of chronic urticaria
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DOI：
10.1111/ddg.12194
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发表时间：
2013-10-01
影响因子：
3.6
通讯作者：
Zuberbier, Torsten
中科院分区：
文献类型：
--
作者：
Maurer, Marcus;Magerl, Markus;Zuberbier, Torsten
2012年底，在第四届国际共识会议（urticaria 2012）上，300多名与会者讨论并同意更新国际荨麻疹指南。目前，这些建议正处于国际协调的最后阶段。在编写最新情况时，一个专家小组编写了问题；随后进行了系统的文献检索。与会者讨论了这些问题和提出的建议，并以公开投票方式作出决定。共识被定义为至少75%的同意。更新后的指南将修改和改进各个领域，特别是治疗方面的现有指南。对于慢性荨麻疹的治疗，新算法推荐了一个三步的过程，从标准剂量的非镇静H1抗组胺药开始。如果没有足够的治疗反应，剂量应该增加到四倍。在治疗难治性患者中，建议在第三步使用奥玛珠单抗、环孢素A或孟鲁司特。短期皮质类固醇治疗最多可考虑10天。H2抗组胺药和氨苯砜，在之前版本的指南中被包括在内，由于证据水平的变化，在更新和修订的版本中没有出现。
At the end of 2012, more than 300 participants discussed and agreed on the update of the international guidelines on urticaria at the 4th International Consensus Meeting (URTICARIA 2012). Currently, the recommendations are in the final process of international coordination. In preparation for the update, questions were prepared by an expert panel; this was followed by a systematic literature search. The questions and the resulting recommendations were discussed by the participants and decided upon in an open vote. Consensus was defined as at least 75% agreement. The updated guidelines will modify and improve the currently available guidelines in various areas, especially in therapy.For the treatment of chronic urticaria, the new algorithm recommends a three-step process starting with a standard dose of a non-sedating H1 antihistamine. If there is an insufficient treatment response, the dosage should be increased up to four times. In therapy refractory patients, omalizumab, cyclosporine A, or montelukast are advised in the third step. Short-term corticosteroid treatment for a maximum of 10 days may be considered. H2 antihistamines and dapsone, which were included in the previous version of the guidelines, are absent in the updated and revised version because of changes in the evidence level.