Predicting inadequate treatment response in children with chronic spontaneous urticaria
Background We aimed to investigate the treatment response and associated factors for loss of control in children with chronic spontaneous urticaria (CSU). Methods A total of 240 CSU patients (aged 0‐17 years) were enrolled in a single‐center study in Korea from May 2014 to May 2019. We retrospective...
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Published in | Pediatric allergy and immunology Vol. 31; no. 8; pp. 946 - 953 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
England
Wiley Subscription Services, Inc
01.11.2020
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Subjects | |
Online Access | Get full text |
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Summary: | Background
We aimed to investigate the treatment response and associated factors for loss of control in children with chronic spontaneous urticaria (CSU).
Methods
A total of 240 CSU patients (aged 0‐17 years) were enrolled in a single‐center study in Korea from May 2014 to May 2019. We retrospectively reviewed the medical records and compared the duration of treatment and step of medications using the urticaria control test (UCT, range 0‐16 points). Serum total immunoglobulin levels, eosinophil count, allergic sensitization, autologous serum skin test, antinuclear antibody, thyroid function test, erythrocyte sedimentation rate, and C‐reactive protein were measured. The patients were divided into well‐controlled (sustained UCT ≥12), partly controlled (fluctuating UCT around 12), and poorly controlled (sustained UCT <12) groups.
Results
Of the 240 children, 150 (62.5%) achieved well‐controlled status; 74 (30.8%), partly controlled; and 16 (6.7%), poorly controlled. Longer duration (adjusted odds ratio: 1.09, 95% confidence interval: 1.05‐1.13, P < .001) and higher treatment steps (5.61, 2.82‐11.14, P < .001) for reaching the initial 12 points or more of UCT score, initial urticaria activity score (UAS) score (1.06, 1.03‐1.09, P < .001), and food sensitization (1.88, 1.03‐3.46, P = .041) were associated with inadequate treatment response. The mean duration to symptom free for 1 month without medication was 14.6 months in the well‐controlled group and 22.1 months in the partly controlled group (P = .002).
Conclusion
Children with CSU have a good treatment response. Longer duration and higher treatment step until the initial disease control, higher initial UAS7 score, and food sensitization can predict inadequate treatment response. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0905-6157 1399-3038 |
DOI: | 10.1111/pai.13319 |