Abstract:
This publication is the second part of the German-language S3 guideline on urticaria. It covers the management of urticaria and should be used together with Part 1 of the guideline on classification and diagnosis. This publication was prepared according to the criteria of the AWMF on the basis of the international English-language S3 guideline with special consideration of health system conditions in German-speaking countries. Chronic urticaria has a high impact on the quality of life and daily activities of patients. Therefore, if causal factors cannot be eliminated, effective symptomatic treatment is necessary. The recommended first-line treatment is to administer new generation, non-sedating H1 antihistamines. If the standard dose is not sufficiently effective, the dose should be increased up to fourfold. For patients who do not respond to this treatment, the second-line treatment in addition to antihistamines in the treatment algorithm is omalizumab and, if this treatment fails, ciclosporin. Other low-evidence therapeutic agents should only be used if all treatments in the treatment algorithm agreed upon by the guideline group fail. Both the benefit-risk profile and cost should be considered. Corticosteroids are not recommended for long-term treatment due to their inevitable severe side effects.
摘要:
本出版物是德语S3关于荨麻疹的指南的第二部分。它涵盖荨麻疹的管理,应与分类和诊断指南的第1部分一起使用。本出版物是根据AWMF的标准根据国际英语S3指南编写的,并特别考虑了德语国家的卫生系统条件。慢性荨麻疹对患者的生活质量和日常活动有很大影响。因此,如果不能消除因果因素,有效的对症治疗是必要的。推荐的一线治疗是管理新一代,非镇静H1抗组胺药。如果标准剂量不够有效,剂量应该增加到四倍。对于对这种治疗没有反应的患者,在治疗算法中,除了抗组胺药之外的二线治疗是奥马珠单抗,如果这种治疗失败,环孢素.只有当指南组同意的治疗算法中的所有治疗都失败时,才应使用其他低证据治疗剂。应同时考虑收益风险状况和成本。皮质类固醇由于其不可避免的严重副作用而不推荐用于长期治疗。