背景:血管水肿(AE)表现为间歇性,局部化,皮下和/或粘膜下组织的自限性肿胀。AE是异质的,可以是遗传的或后天的,只发生一次或反复发生,有或没有风头,由于肥大细胞介体,缓激肽或其他机制。目前,使用不同的分类系统,很难比较研究结果,发展多中心协作,并协调AE患者的治疗。
目的:为了就定义达成共识,首字母缩略词,命名法,和血管性水肿的分类(DANCE)。
方法:该倡议涉及来自35个国家的91名专家,得到了53名科学、医学社会,患者组织。在16个月的时间内(2021年6月至2022年11月),使用Delphi流程通过在线讨论和投票达成了共识。
结果:DANCE倡议在定义上达成了国际共识,AE的分类和术语。新的共识分类具有AE的五种类型和内生型以及缩写和首字母缩写词的统一词汇。
结论:DANCE分类补充了当前临床指南和关于AE诊断和治疗的专家共识建议。DANCE不能取代当前的临床指南和专家共识算法,并且不应以影响医生使用合理的临床判断开具的药物报销的方式进行误解。我们预计新的AE分类法和命名法将协调和促进AE研究和临床研究,从而改善患者护理。
BACKGROUND: Angioedema (AE) manifests with intermittent, localized, self-limiting swelling of the subcutaneous and/or submucosal tissue. AE is heterogeneous, can be hereditary or acquired, may occur only once or be recurrent, may exhibit wheals or not, and may be due to mast cell mediators, bradykinin, or other mechanisms. Several different taxonomic systems are currently used, making it difficult to compare the results of studies, develop multicenter collaboration, and harmonize AE treatment.
OBJECTIVE: We developed a consensus on the definition, acronyms, nomenclature, and classification of AE (DANCE).
METHODS: The initiative involved 91 experts from 35 countries and was endorsed by 53 scientific and medical societies, and patient organizations. A consensus was reached by online discussion and voting using the Delphi process over a period of 16 months (June 2021 to November 2022).
RESULTS: The DANCE initiative resulted in an international consensus on the definition, classification, and terminology of AE. The new consensus classification features 5
types and endotypes of AE and a harmonized vocabulary of abbreviations/acronyms.
CONCLUSIONS: The DANCE classification complements current clinical guidelines and expert consensus recommendations on the diagnostic assessment and treatment of AE. DANCE does not replace current clinical guidelines, and expert consensus algorithms and should not be misconstrued in a way that affects reimbursement of medicines prescribed by physicians using sound clinical judgment. We anticipate that this new AE taxonomy and nomenclature will harmonize and facilitate AE research and clinical studies, thereby improving patient care.