Department of Dermatology, College of Medicine and Sagore Dutta Hospital, Kolkata, India.
Urticaria Center of Reference and Excellence (UCARE), Department of Dermatology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, Istanbul, Turkiye.
Expert Rev Clin Immunol. 2024 Dec;20(12):1427-1435. doi: 10.1080/1744666X.2024.2388689. Epub 2024 Nov 18.
There is a significant prevalence of chronic spontaneous urticaria (CSU) in children across the globe. Some children with CSU do not achieve disease control with first-line antihistamine treatment and may need anti-IgE therapy with omalizumab. Recently, several novel treatment options, including dupilumab and BTK inhibitors, showed promising results in the treatment of antihistamine-refractory CSU in adults. However, information regarding their use in pediatric CSU is scarce, and most data is extrapolated from adult studies.
The review highlights the evidence on the use of mAbs and small-molecule inhibitors in pediatric CSU and aims to bridge the knowledge gaps and highlight unmet needs.
Omalizumab is approved for allergic asthma patients aged ≥6 years, and some experience with omalizumab in children with CSU at this age has been published. However, approximately 5-10% of pediatric CSU patients may show insufficient response to omalizumab, necessitating other therapies. The available information on the off-label use of biologics other than omalizumab in children is limited to case reports. No data is available for other new therapies.
在全球范围内，儿童慢性自发性荨麻疹（CSU）的患病率很高。一些患有 CSU 的儿童不能通过一线抗组胺治疗来控制疾病，可能需要奥马珠单抗的抗 IgE 治疗。最近，一些新型治疗选择，包括度普利尤单抗和 BTK 抑制剂，在成人抗组胺难治性 CSU 的治疗中显示出了有希望的结果。然而，关于它们在儿科 CSU 中的应用的信息很少，并且大多数数据是从成人研究中推断出来的。
该综述强调了 mAbs 和小分子抑制剂在儿科 CSU 中的应用证据，并旨在弥合知识差距，突出未满足的需求。
奥马珠单抗批准用于年龄≥6 岁的过敏性哮喘患者，并且已经发表了一些关于该年龄组 CSU 患者使用奥马珠单抗的经验。然而，约 5-10%的儿科 CSU 患者可能对奥马珠单抗反应不足，需要其他治疗方法。关于儿童中除奥马珠单抗以外的生物制剂的标签外使用的可用信息仅限于病例报告。其他新疗法的数据尚不可用。
