Prevalence and clinical characteristics of chronic spontaneous urticaria in pediatric patients.

Authors:
Karsten Weller
Karsten Weller
Charité-Universitätsmedizin Berlin
Germany
Charis Papavassilis
Charis Papavassilis
National Taiwan University Hospital and National Taiwan University College of Medicine
Taiwan
Thomas Severin
Thomas Severin
Medical University
Poland
Haijun Tian
Haijun Tian
Albert Einstein College of Medicine
United States
Torsten Zuberbier
Torsten Zuberbier
Charité-Universitätsmedizin Berlin
Germany

Pediatr Allergy Immunol 2018 Sep 11;29(6):630-636. Epub 2018 Jul 11.

Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Background: Data on the prevalence and disease management of chronic urticaria (CU) and chronic spontaneous urticaria (CSU) in the pediatric population are scarce. This study assessed the prevalence of CU and CSU, and disease management among pediatric patients (0-17 years).

Methods: A physician-based online survey was conducted in 5 European countries (United Kingdom, Germany, Italy, France, and Spain) assessing the annual diagnosed prevalence, disease characteristics, and treatment patterns in the target population. Results are based on physician responses and analyzed using descriptive statistics. Prevalence estimates were calculated based on the number of CU/CSU pediatric patients diagnosed, seen, and treated by the respondents and extrapolated to the total pediatric population from each country.

Results: Across 5 European countries, the one-year diagnosed prevalence of CU and CSU in pediatric patients was 1.38% (95% CI, 0.94-1.86) and 0.75% (95% CI, 0.44-1.08), respectively. Angioedema was reported in 6%-14% of patients. A large proportion of CSU pediatric patients (40%-60%) were treated with H1-antihistamines at approved dose and 16%-51% received H1-antihistamines at higher doses. Approximately 1/3 of pediatric CSU patients remained uncontrolled with H1-antihistamines at approved/higher doses. Other prescribed treatments were oral corticosteroids (10%-28%) and topical creams (15%-26%).

Conclusions: This study revealed a prevalence of CSU among pediatric population comparable to adults and also suggested an unmet need for approved treatments for inadequately controlled pediatric CSU patients. It is truly of concern that harmful (oral steroids) or insufficient (topical creams) treatments were frequently used despite better and guideline-recommended alternatives.

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http://dx.doi.org/10.1111/pai.12910DOI Listing

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September 2018
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