Jorge Sánchez1, Leidy Álvarez2,3, Ricardo Cardona1. 1. Group of Clinical and experimental Allergy, Hospital Alma Mater de Antioquia, University of Antioquia, Colombia. 2. Academic Group of Clinical Epidemiology (GRAEPIC), University of Antioquia, Colombia. 3. Technological Evaluations Group, SURA Company, Colombia.
Abstract
Background: Population and study's methodology heterogenicity became clinical evolution of chronic spontaneous urticaria (CSU) highly variable. Objective: In a prospective cohort, we evaluated the different pathways of clinical evolution of CSU and identified possible risk factors. Methods: A total of 685 CSU patients (>12 years) were prospectively followed over 5 years. Diagnosis and follow-up of urticaria were based on medical evaluation and photographic records. Remission was defined as at least 6 months without symptoms (hives, angioedema, or pruritus) and medication. The follow-up included at least 2 visits per year, with photographic registration and clinical evaluation. Predefined clinical and paraclinical variables were included in the regression analyses. Results: We identified four clinical evolution pathways; The cumulative prevalence of remission at 5 years was 59.1%, recurrence was 17.1%, persistence was 11.6%, and chronic pruritus without hives or angioedema was 12.2%. The probability of persistence increased with hypothyroidism diagnosis (HR 0.425, 95% CI 0.290-0.621) and each point in the UAS7 (HR 0.931 95% CI 0.918-0.945). Conclusion: Chronic urticaria has different evolutions. Disease activity and hypothyroidism predict persistence and remission. Recurrence and chronic pruritus phenotypes require further study to evaluate their causality and prognosis.
Background: Population and study's methodology heterogenicity became clinical evolution of chronic spontaneous urticaria (CSU) highly variable. Objective: In a prospective cohort, we evaluated the different pathways of clinical evolution of CSU and identified possible risk factors. Methods: A total of 685 CSU patients (>12 years) were prospectively followed over 5 years. Diagnosis and follow-up of urticaria were based on medical evaluation and photographic records. Remission was defined as at least 6 months without symptoms (hives, angioedema, or pruritus) and medication. The follow-up included at least 2 visits per year, with photographic registration and clinical evaluation. Predefined clinical and paraclinical variables were included in the regression analyses. Results: We identified four clinical evolution pathways; The cumulative prevalence of remission at 5 years was 59.1%, recurrence was 17.1%, persistence was 11.6%, and chronic pruritus without hives or angioedema was 12.2%. The probability of persistence increased with hypothyroidism diagnosis (HR 0.425, 95% CI 0.290-0.621) and each point in the UAS7 (HR 0.931 95% CI 0.918-0.945). Conclusion: Chronic urticaria has different evolutions. Disease activity and hypothyroidism predict persistence and remission. Recurrence and chronic pruritus phenotypes require further study to evaluate their causality and prognosis.
Authors: P Gaig; M Olona; D Muñoz Lejarazu; M T Caballero; F J Domínguez; S Echechipia; J L García Abujeta; M A Gonzalo; R Lleonart; C Martínez Cócera; A Rodríguez; M Ferrer Journal: J Investig Allergol Clin Immunol Date: 2004 Impact factor: 4.333
Authors: Luis Caraballo; Josefina Zakzuk; Bee Wah Lee; Nathalie Acevedo; Jian Yi Soh; Mario Sánchez-Borges; Elham Hossny; Elizabeth García; Nelson Rosario; Ignacio Ansotegui; Leonardo Puerta; Jorge Sánchez; Victoria Cardona Journal: World Allergy Organ J Date: 2016-06-27 Impact factor: 4.084
Authors: Richard D Riley; Jill A Hayden; Ewout W Steyerberg; Karel G M Moons; Keith Abrams; Panayiotis A Kyzas; Núria Malats; Andrew Briggs; Sara Schroter; Douglas G Altman; Harry Hemingway Journal: PLoS Med Date: 2013-02-05 Impact factor: 11.069