背景:慢性自发性(以前称为特发性)荨麻疹(CSU)是一种慢性皮肤病,具有自然缓解的潜力。这篇有针对性的文献综述的目的是确定CSU临床病程的证据,包括缓解率,并估计不同时间点的累积缓解率。
方法:电子数据库(MEDLINE,MEDLINE-In流程,Embase,WebofScience,搜索了BIOSIS预览和Cochrane图书馆)和相关会议记录,以确定涉及年龄≥12岁的CSU患者的研究,这些研究提供了缓解率和疾病持续时间的数据。包括患者随访≥1年或评论文章的观察性研究。从五项选定的研究中提取的数据用于运行Kaplan-Meier(KM)分析和最佳拟合分布,以计算每4周的缓解率和加权平均值。
结果:本综述包括10篇出版物。在第1年内达到缓解的患者比例为21%至47%,而第5年报告的缓解率估计为34%和45%。根据计算的4周缓解率,累计缓解估计值在第1年为9%~38%,在第5年为29%~71%,在第20年为52%~93%.在第1年、第5年和第20年缓解的患者比例的累积加权平均估计值为17%,45%和73%,分别。
结论:已发表的证据表明,CSU是一种具有不同疾病严重程度和持续时间的自限性疾病,显然取决于多种因素。然而,数据来源在疾病严重程度和缓解的定义方面有所不同,以及影响因素的结论。需要进一步的研究和统一的定义。
BACKGROUND: Chronic spontaneous (previously known as idiopathic) urticaria (CSU) is a chronic skin disease with the potential for natural remission. The objectives of this targeted literature
review were to identify evidence on the clinical course of CSU, including remission rates, and to estimate cumulative remission rates for different time points.
METHODS: Electronic databases (MEDLINE, MEDLINE-In Process, Embase, Web of Science, BIOSIS Previews and the Cochrane Library) and relevant conference proceedings were searched to identify studies involving patients with CSU aged ≥ 12 years that provide data on remission rates and disease duration. Observational studies with patient follow-ups of ≥ 1 year or
review articles were included. Data extracted from five selected studies were used to run Kaplan-Meier (KM) analyses and best-fit distributions to calculate remission rates per 4-week period and weighted averages.
RESULTS: Ten publications were included in this
review. The proportion of patients achieving remission within year 1 ranged from 21 to 47%, while reported remission rate estimates at year 5 were 34% and 45%. Based on calculated 4-weekly remission rates, cumulative remission estimates ranged from 9 to 38% at year 1, from 29 to 71% at year 5 and from 52 to 93% at year 20. Cumulative weighted average estimates for the proportion of patients remitting at years 1, 5 and 20 were 17%, 45% and 73%, respectively.
CONCLUSIONS: Published evidence suggests that CSU is a self-limiting condition with variable disease severity and duration, apparently dependent on multiple factors. However, data sources differed in terms of definitions of disease severity and remission, as well as in conclusions on influencing factors. Further studies and uniform definitions are required.