Consensus on the diagnostic and therapeutic management of chronic spontaneous urticaria in adults - Brazilian Society of Dermatology
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Citações na Scopus
6
Tipo de produção
article
Data de publicação
2019
Editora
SOC BRASILEIRA DERMATOLOGIA
Indexadores
Título da Revista
ISSN da Revista
Título do Volume
Autores
ALCHORNE, Alice de Oliveira de Avelar
RAMOS, Andrea Machado Coelho
GONTIJO, Bernardo
SANTOS, Josemir Belo dos
MARTINS, Luis Eduardo Agner Machado
SILVARES, Maria Regina Cavariani
Autor de Grupo de pesquisa
Editores
Coordenadores
Organizadores
Citação
ANAIS BRASILEIROS DE DERMATOLOGIA, v.94, n.2, suppl.1, p.S56-S66, 2019
Resumo
BACKGROUND: Urticarias are frequent diseases, with 15% to 20% of the population presenting at least one acute episode in their lifetime. Urticaria are classified in acute (<= 6 weeks) or chronic (> 6 weeks). They may be induced or spontaneous. OBJECTIVES: To verify the diagnostic and therapeutic recommendations in chronic spontaneous urticaria (CSU), according to the experience of Brazilian experts, regarding the available guidelines (international and US). Methods: A questionnaire was sent to Brazilian experts, with questions concerning diagnostic and therapeutic recommendations for CSU in adults. RESULTS: Sixteen Brazilian experts answered the questionnaire related to diagnosis and therapy of CSU in adults and data were analyzed. Final text was written, considering the available guidelines (International and US), adapted to the medical practices in Brazil. Diagnostic work up in CSU is rarely necessary. Biopsy of skin lesion and histopathology may be indicated to rule out other diseases, such as, urticarial vasculitis. Other laboratory tests, such as complete blood count, CRP, ESR and thyroid screening. Treatment of CSU includes second-generation anti-histamines (sgAH) at licensed doses, sgAH two, three to fourfold doses (non-licensed) and omalizumab. Other drugs, such as, cyclosporine, immunomodulatory drugs and immunosuppressants may be indicated (non-licensed and with limited scientific evidence). CONCLUSIONS: Most of the Brazilian experts in this study partially agreed with the diagnostic and therapeutic recommendations of the International and US guidelines. They agreed with the use of sgAH at licensed doses. Increase in the dose to fourfold of sgAH may be suggested with restrictions, due to its non-licensed dose. Sedating anti-histamines, as suggested by the US guideline, are indicated by some of the Brazilian experts, due to its availability. Adaptations are mandatory in the treatment of CSU, due to scarce or lack of other therapeutic resources in the public health system in Brazil, such as omalizumab or cyclosporine.
Palavras-chave
Cyclosporine, Dapsone, Histamine antagonists, Methotrexate, Omalizumab, Urticaria, Urticaria/etiology, Urticaria/therapy
Referências
- Al-Ahmad M, 2016, CLINICOECONOMIC OUTC, V8, P163, DOI 10.2147/CEOR.S98848
- Antia C, 2018, J AM ACAD DERMATOL, V79, P617, DOI 10.1016/j.jaad.2018.01.023
- Asero R, 2013, AM J CLIN DERMATOL, V14, P481, DOI 10.1007/s40257-013-0047-3
- Bernstein JA, 2014, J ALLERGY CLIN IMMUN, V133, P1270, DOI 10.1016/j.jaci.2014.02.036
- Broder MS, 2015, AM J CLIN DERMATOL, V16, P313, DOI 10.1007/s40257-015-0134-8
- COOPER KD, 1991, J AM ACAD DERMATOL, V25, P166, DOI 10.1016/0190-9622(91)70184-4
- Criado PR, 2015, AN BRAS DERMATOL, V90, P74, DOI 10.1590/abd1806-4841.20153509
- Criado RFJ, 2008, J DERMATOL TREAT, V19, P92, DOI 10.1080/09546630701499309
- Curto-Barredo L, 2018, ACTA DERM-VENEREOL, V98, P641, DOI 10.2340/00015555-2941
- DeLong LK, 2008, ARCH DERMATOL, V144, P35, DOI 10.1001/archdermatol.2007.5
- Ferrer M, 2017, ALLERGOL IMMUNOPA S1, V45, pS41
- Ghazanfar MN, 2015, CASE REP MED, DOI 10.1155/2015/368053
- Graham J, 2016, PHARMACOECONOMICS, V34, P815, DOI 10.1007/s40273-016-0412-1
- Koski R, 2017, ANN ALLERG ASTHMA IM, V119, P397, DOI 10.1016/j.anai.2017.07.029
- Kulthanan K, 2018, J ALLER CL IMM-PRACT, V6, P586, DOI 10.1016/j.jaip.2017.07.017
- Morgan M, 2014, J ALLER CL IMM-PRACT, V2, P601, DOI 10.1016/j.jaip.2014.06.004
- Namazy J, 2015, J ALLERGY CLIN IMMUN, V135, P407, DOI 10.1016/j.jaci.2014.08.025
- O'Donnell BF, 2014, IMMUNOL ALLERGY CLIN, V34, P89, DOI 10.1016/j.iac.2013.09.011
- ODonnell BF, 1997, BRIT J DERMATOL, V136, P197
- Ortonne JP, 2012, EUR J INTERN MED, V23, P26, DOI 10.1016/j.ejim.2011.09.008
- Parisi Claudio Alberto Salvador, 2016, Value Health Reg Issues, V11, P57, DOI 10.1016/j.vhri.2016.07.008
- Perez A, 2010, BRIT J DERMATOL, V162, P191, DOI 10.1111/j.1365-2133.2009.09538.x
- Pho LN, 2011, J DRUGS DERMATOL, V10, P1423
- Reeves GEM, 2004, INTERN MED J, V34, P182, DOI 10.1111/j.1444-0903.2004.00532.x
- Sagi L, 2011, ACTA DERM-VENEREOL, V91, P303, DOI 10.2340/00015555-1080
- Schwarz EB, 2008, DRUG SAFETY, V31, P775, DOI 10.2165/00002018-200831090-00006
- Tedeschi A, 2003, AM J CLIN DERMATOL, V4, P297, DOI 10.2165/00128071-200304050-00001
- Weber-Schoendorfer C, 2008, REPROD TOXICOL, V26, P19, DOI 10.1016/j.reprotox.2008.05.053
- Weller K, 2011, PLOS ONE, V6, DOI 10.1371/journal.pone.0023931
- Williams PV, 2018, DERMATOLOGY THER, V8, P69, DOI 10.1007/s13555-018-0225-6
- Wood RA, 2018, ALLERGY
- Zhao ZT, 2016, J ALLERGY CLIN IMMUN, V137, P1742, DOI 10.1016/j.jaci.2015.12.1342
- Zuberbier T, 2018, ALLERGY, V73, P1393, DOI 10.1111/all.13397
- Zuberbier T, 2014, ALLERGY, V69, P868, DOI 10.1111/all.12313
- Zuberbier T, 2012, J EUR ACAD DERMATOL, V26, P9, DOI 10.1111/j.1468-3083.2011.04185.x
- Zuberbier T, 2001, J INVEST DERM SYMP P, V6, P123, DOI 10.1046/j.0022-202x.2001.00022.x
- Zuberbier T, 2018, J ALLER CL IMM-PRACT, V6, P1144, DOI 10.1016/j.jaip.2018.04.012