Novartis Pharma AG, Basel, Switzerland.
Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Pediatr Allergy Immunol. 2018 Sep;29(6):630-636. doi: 10.1111/pai.12910. Epub 2018 Jul 11.
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).
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.
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%).
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.
儿童慢性荨麻疹(CU)和慢性自发性荨麻疹(CSU)的患病率和疾病管理数据稀缺。本研究评估了儿科患者(0-17 岁)中 CU 和 CSU 的患病率和疾病管理情况。
在 5 个欧洲国家(英国、德国、意大利、法国和西班牙)进行了一项基于医生的在线调查,评估了目标人群中的年诊断患病率、疾病特征和治疗模式。结果基于医生的回答,并使用描述性统计进行分析。患病率估计数是根据受访者诊断、就诊和治疗的 CU/CSU 儿科患者人数计算得出,并从每个国家的儿科总人口中推断得出。
在 5 个欧洲国家中,儿科患者 CU 和 CSU 的一年诊断患病率分别为 1.38%(95%CI,0.94-1.86)和 0.75%(95%CI,0.44-1.08)。报告称,6%-14%的患者出现血管性水肿。相当一部分 CSU 儿科患者(40%-60%)以批准剂量接受 H1 抗组胺药治疗,16%-51%接受高剂量 H1 抗组胺药治疗。大约 1/3 的儿科 CSU 患者在用批准剂量/高剂量 H1 抗组胺药治疗时仍未得到控制。其他处方治疗包括口服皮质类固醇(10%-28%)和局部乳膏(15%-26%)。
本研究显示,CSU 在儿科人群中的患病率与成人相当,也表明对于未得到充分控制的儿科 CSU 患者,需要批准的治疗方法。尽管有更好的、符合指南的替代方法,但经常使用有害(口服类固醇)或不足(局部乳膏)的治疗方法,这确实令人担忧。