Zuberbier Torsten, Altrichter Sabine, Bauer Sabine, Brehler Randolf, Brockow Knut, Dressler Corinna, Fluhr Joachim, Gaskins Matthew, Hamelmann Eckard, Kühne Kathrin, Merk Hans, Mülleneisen Norbert K, Nast Alexander, Olze Heidi, Ott Hagen, Pleimes Marc, Ruëff Franziska, Staubach-Renz Petra, Wedi Bettina, Maurer Marcus
Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.
J Dtsch Dermatol Ges. 2023 Feb;21(2):202-215. doi: 10.1111/ddg.14932. Epub 2023 Feb 2.
This publication is the second part of the German-language S3 guideline on urticaria. It covers the management of urticaria and should be used together with Part 1 of the guideline on classification and diagnosis. This publication was prepared according to the criteria of the AWMF on the basis of the international English-language S3 guideline with special consideration of health system conditions in German-speaking countries. Chronic urticaria has a high impact on the quality of life and daily activities of patients. Therefore, if causal factors cannot be eliminated, effective symptomatic treatment is necessary. The recommended first-line treatment is to administer new generation, non-sedating H1 antihistamines. If the standard dose is not sufficiently effective, the dose should be increased up to fourfold. For patients who do not respond to this treatment, the second-line treatment in addition to antihistamines in the treatment algorithm is omalizumab and, if this treatment fails, ciclosporin. Other low-evidence therapeutic agents should only be used if all treatments in the treatment algorithm agreed upon by the guideline group fail. Both the benefit-risk profile and cost should be considered. Corticosteroids are not recommended for long-term treatment due to their inevitable severe side effects.
本出版物是德语版荨麻疹S3指南的第二部分。它涵盖了荨麻疹的管理，应与分类和诊断指南的第一部分一起使用。本出版物是根据德国医学科学院（AWMF）的标准，在国际英语版S3指南的基础上，并特别考虑了德语国家的卫生系统情况编写而成。慢性荨麻疹对患者的生活质量和日常活动有很大影响。因此，如果无法消除病因，有效的对症治疗是必要的。推荐的一线治疗方法是使用新一代非镇静性H1抗组胺药。如果标准剂量效果不佳，剂量可增加至四倍。对于对此治疗无反应的患者，治疗方案中除抗组胺药外的二线治疗药物是奥马珠单抗，若该治疗失败，则使用环孢素。只有在指南小组商定的治疗方案中的所有治疗均失败时，才可使用其他证据不足的治疗药物。应同时考虑获益风险情况和成本。由于皮质类固醇不可避免地会产生严重副作用，因此不推荐长期使用。
