Armstrong April W, Soong Weily, Bernstein Jonathan A
Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Alabama Allergy and Asthma Center and Clinical Research Center of Alabama, Birmingham, AL, USA.
Dermatol Ther (Heidelb). 2023 Aug;13(8):1629-1646. doi: 10.1007/s13555-023-00955-7. Epub 2023 Jun 24.
Chronic spontaneous urticaria (CSU) is a complex skin disease characterized by the spontaneous appearance of wheals, angioedema, or both, for more than 6 weeks. Many patients experience a relapsing-remitting disease course for years. Owing to the unpredictability of wheal recurrence and the severity of pruritis, patients suffer considerable impairment in their quality of life. Physicians face multiple challenges, not least of which is a lack of clear guidance on what constitutes "treatment success". There is a lack of awareness of which measures should be used to best assess the various aspects of CSU, including disease activity, disease control, and quality of life-which themselves each comprise multiple components-and how to apply the results of each score to treatment decision-making. Although the overarching aim of treatment is for patients to be completely free of signs and symptoms of CSU, a more realistic definition of "treatment success" is needed to guide ongoing, long-term disease management for each individual patient. In this review, we consider what lessons can be learned from the current evidence base to provide further direction toward a universal definition of "treatment success".
慢性自发性荨麻疹（CSU）是一种复杂的皮肤病，其特征为风团、血管性水肿或两者同时自发出现，持续超过6周。许多患者多年来经历复发-缓解的病程。由于风团复发的不可预测性和瘙痒的严重程度，患者的生活质量受到相当大的损害。医生面临多重挑战，其中最主要的是缺乏关于何为“治疗成功”的明确指导。对于应使用哪些措施来最佳评估CSU的各个方面，包括疾病活动度、疾病控制和生活质量（这些方面本身又各自包含多个组成部分），以及如何将每个评分结果应用于治疗决策，人们缺乏认识。尽管治疗的总体目标是让患者完全摆脱CSU的体征和症状，但需要一个更现实的“治疗成功”定义来指导针对每个患者的持续长期疾病管理。在本综述中，我们探讨可以从当前证据基础中学到哪些经验教训，以进一步朝着“治疗成功”的通用定义提供指导。
