Clinical experience of a chronic urticaria university referral center

G. Andrade Coelho Dias gabrielaacdias@gmail.com ¹, F. Cunha Coelho¹, P. Filippo¹, D. Lacerda Pedrazzi¹, A.C. Nogueira Arraes¹, M.I. Perelló¹, F. Chigres Kuschnir¹, E. Costa²
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Doi
https://doi.org/10.23822/EurAnnACI.1764-1489.103

Summary
Objective. Describe routine procedures, clinical profile and evolution of patients treated in a chronic urticaria (CU) reference center of a university hospital. Methods. Retrospective analysis of clinical records and database of CU patients registered between March 2011 and February 2016 in a reference center. Besides, demographic characteristics were recorded: disease duration, comorbidities, angioedema, thyroid lab tests, urticaria subtypes, provocation tests, UAS and CUQ2oL scores. Patients with 3 or more visits were included in analysis regarding the first and last visits to evaluate pharmacological treatment and differences of UAS/CUQ2oL scores, antihistamines (anti-H1) dosages and need of other medications, according urticaria subtypes. Results. During the study, 252 patients were attended, 200 with CU, including 162 women, median age 45 years (perc 25 - 75 = 27 - 58) and median duration of symptoms before diagnosis: 24 months (perc 25 - 75 = 9 - 60). Regarding the etiology, 166 (83%) patients had chronic spontaneous urticaria (CSU), 34 (17%) had isolated chronic inducible urticaria (CIndU), and 66 (33%) CSU with CIndU. Among the 123 patients followed up for 3 or more visits, first prescription to 106 (86.2%) patients was monotherapy with anti-H1, and associations with other medications were prescribed to 17 (13.8%). At the last visit, 94 (76.5%) received antihistamines, and 29 (23.5%) used associations. Patients with CSU + CIndU + ASST positive need more association of anti-H1 with other medications than patients with CSU + CIndU and only CIndU (÷2 = 7.998; p = 0.01). Between first and last visits CUQ2oL mean scores changed from 35.7 (± 21.9) to 22.6 (± 21.0) (Z = -4.833 p < 0.000). Conclusion. Most of the patients presented CSU, associated frequently with CIndU. All patients were treated with antihistamines and there was a great need for doses above standardized, and also for combination with other medications, with improved quality of life during the follow-up period.

Key words
chronic urticaria; treatment; antihistamines; urticaria activity score; quality of life
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