背景:慢性诱导型荨麻疹(CIndU)是慢性荨麻疹(CU)的一种亚型,这需要特定的触发器发生。尽管它们很常见,治疗反应率和治疗反应的预测因子在文献中很大程度上缺乏.这项研究评估了最常见的CIndU亚型中的抗组胺药(AH)和奥马珠单抗反应率,并检查了某些特征是否可以预测治疗反应。
方法:我们回顾性分析了至少有一个CIndU亚型的CU患者,并进行了亚组之间的比较,在总共423名患者中(70%CIndU,30%慢性自发性荨麻疹[CSU]plusCIndU)。
结果:CIndU的治疗反应率为51.6%,51.5%,86.5%使用标准剂量第二代H1-抗组胺药(sgAHs),updosed/combinedsgAH,和奥马珠单抗,分别。总体AH反应在CIndU高于CSUplusCIndU(78.3%vs.62%,p=0.002)和症状性皮肤病学(SD)和冷荨麻疹(ColdU)比胆碱能性荨麻疹(ChoU)(83.2%vs.78.3vs.60.9%,p=0.04)。AH难治性患者的病程较长(45.2±56.7个月与37±51.9个月,p=0.04),更多的血管性水肿,陪同CSU,mixedCIndU亚型(37.5%与21.1%,p=0.003;45.1%vs.27.1%,p=0.002;8.8%vs.2.4%,p=0.014),和较低的基线荨麻疹控制测试得分(5.86±3.3vs.8.6±3.6,p<0.001)比AH敏感患者。
结论:CIndU对AHs和奥马珠单抗均表现出良好的反应。值得注意的是,与ChoU相比,SD和ColdU对AHs的反应更为明显。疾病持续时间,血管性水肿,陪同CSU,mixedCIndU,较低的基线UCT评分可用于预测CIndU的AH治疗结果。
BACKGROUND: Chronic inducible urticaria (CIndU) is a subtype of chronic urticaria (CU), which requires specific triggers to occur. Despite their common occurrence, treatment response rates and predictors of treatment responses are largely lacking in the literature. This study evaluates antihistamine (AH) and omalizumab response rates in the most common CIndU subtypes and examines whether certain features can predict treatment responses.
METHODS: We retrospectively analyzed CU patients with at least one CIndU subtype and performed comparisons between subgroups, in a total of 423 patients (70% CIndU, 30% chronic spontaneous urticaria [CSU] plus CIndU).
RESULTS: The treatment response rates in CIndU were 51.6%, 51.5%, and 86.5% with standard-dose second-generation H1-antihistamines (sgAHs), updosed/combined sgAH, and omalizumab, respectively. Overall AH response was higher in CIndU than CSU plus CIndU (78.3% vs. 62%, p = 0.002) and in symptomatic dermographism (SD) and cold urticaria (ColdU) than cholinergic urticaria (ChoU) (83.2% vs. 78.3 vs. 60.9%, p = 0.04). AH-refractory patients had a longer disease duration (45.2 ± 56.7 months vs. 37 ± 51.9 months, p = 0.04), more angioedema, accompanying CSU, mixed CIndU subtypes (37.5% vs. 21.1%, p = 0.003; 45.1% vs. 27.1%, p = 0.002; 8.8% vs. 2.4%, p = 0.014), and lower baseline urticaria control test scores (5.86 ± 3.3 vs. 8.6 ± 3.6, p < 0.001) than AH-responsive patients.
CONCLUSIONS: CIndU exhibits a good response to both AHs and omalizumab. Notably, the response to AHs is more pronounced in SD and ColdU compared to ChoU. Disease duration, angioedema, accompanying CSU, mixed CIndU, and lower baseline UCT scores may be used to predict AH treatment outcome in CIndU.