EAACI/GA(2)LEN/EDF/WAO guideline: management of urticaria.
This guideline, together with its sister guideline on the classification of urticaria (Zuberbier T, Asero R, Bindslev-Jensen C, Canonica GW, Church MK, Giménez-Arnau AM et al. EAACI/GA(2)LEN/EDF/WAO Guideline: definition, classification and diagnosis of urticaria. Allergy 2009;64: 1417-1426), is the result of a consensus reached during a panel discussion at the Third International Consensus Meeting on Urticaria, Urticaria 2008, a joint initiative of the Dermatology Section of the European Academy of Allergology and Clinical Immunology (EAACI), the EU-funded network of excellence, the Global Allergy and Asthma European Network (GA(2)LEN), the European Dermatology Forum (EDF) and the World Allergy Organization (WAO). As members of the panel, the authors had prepared their suggestions regarding management of urticaria before the meeting. The draft of the guideline took into account all available evidence in the literature (including Medline and Embase searches and hand searches of abstracts at international allergy congresses in 2004-2008) and was based on the existing consensus reports of the first and the second symposia in 2000 and 2004. These suggestions were then discussed in detail among the panel members and with the over 200 international specialists of the meeting to achieve a consensus using a simple voting system where appropriate. Urticaria has a profound impact on the quality of life and effective treatment is, therefore, required. The recommended first line treatment is new generation, nonsedating H(1)-antihistamines. If standard dosing is not effective, increasing the dosage up to four-fold is recommended. For patients who do not respond to a four-fold increase in dosage of nonsedating H(1)-antihistamines, it is recommended that second-line therapies should be added to the antihistamine treatment. In the choice of second-line treatment, both their costs and risk/benefit profiles are most important to consider. Corticosteroids are not recommended for long-term treatment due to their unavoidable severe adverse effects. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS).
Zuberbier
T
T
Department of Dermatology and Allergy, Charité- Universitätsmedizin Berlin, Berlin, Germany.
Asero
R
R
Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano (MI), Italy.
Bindslev-Jensen
C
C
Allergy Centre, Department of Dermatology, Odense University Hospital, Odense Area, Denmark.
Walter Canonica
G
G
Allergy and Respiratory Diseases, DIMI - University of Genoa, Genoa, Italy.
Church
M K
MK
Department of Dermatology and Allergy, Charité- Universitätsmedizin Berlin, Berlin, Germany.
Giménez-Arnau
A M
AM
Department of Dermatology, Hospital del Mar, IMAS, Universitat Autònoma of Barcelona, Barcelona, Spain.
Grattan
C E H
CEH
Dermatology Centre, Norfolk & Norwich University Hospital, Norwich, UK.
Kapp
A
A
Department of Dermatology and Allergology, Hannover Medical University, Hannover, Germany.
Maurer
M
M
Department of Dermatology and Allergy, Charité- Universitätsmedizin Berlin, Berlin, Germany.
Merk
H F
HF
Department of Dermatology, University Hospital RWTH Aachen, Aachen, Germany.
Rogala
B
B
Clinical Department of Internal Diseases, Allergology and Clinical Immunology, Medical University of Silesia, Katowice, Poland.
Saini
S
S
Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Sánchez-Borges
M
M
Allergy and Immunology Department, Centro Medico-Docente La Trinidad, Caracas, Venezuela.
Schmid-Grendelmeier
P
P
Allergy Unit, Department of Dermatology, University Hospital, Zurich, Switzerland.
Schünemann
H
H
Department of Clinical Epidemiology & Biostatistics, Hamilton, Canada.
Staubach
P
P
Department of Clinical Epidemiology & Biostatistics, Hamilton, Canada.
Vena
G A
GA
Department of Dermatology, Johannes Gutenberg-University Mainz, Mainz, Germany.
Wedi
B
B
Department of Dermatology and Allergology, Hannover Medical University, Hannover, Germany.
D000328:Adult; D018926:Anti-Allergic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D005260:Female; D039563:Histamine H1 Antagonists, Non-Sedating / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D011247:Pregnancy; D011788:Quality of Life; D016896:Treatment Outcome; D014581:Urticaria / Q000175:diagnosis / Q000188:drug therapy* / Q000628:therapy*
D018926:Anti-Allergic Agents; D039563:Histamine H1 Antagonists, Non-Sedating