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1. Transient improvement of urticaria induces poor adherence as assessed by Morisky Medication Adherence Scale‐8

Author

Kaneko, Sakae, Masuda, Koji, Hiragun, Takaaki, Inomata, Naoko, Furue, Masutaka, Onozuka, Daisuke, Takeuchi, Satoshi, Murota, Hiroyuki, Sugaya, Makoto, Saeki, Hidehisa, Shintani, Yoichi, Tsunemi, Yuichiro, Abe, Shinya, Kobayashi, Miwa, Kitami, Yuki, Tanioka, Miki, Imafuku, Shinichi, Abe, Masatoshi, Hagihara, Akihito, Morisky, Donald E, and Katoh, Norito

Subjects
Pharmacology and Pharmaceutical Sciences, Biomedical and Clinical Sciences, Clinical Research, 5.1 Pharmaceuticals, Management of diseases and conditions, Evaluation of treatments and therapeutic interventions, Development of treatments and therapeutic interventions, 6.1 Pharmaceuticals, 7.1 Individual care needs, Administration, Oral, Administration, Topical, Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Japan, Male, Medication Adherence, Middle Aged, Surveys and Questionnaires, Urticaria, Young Adult, adherence, oral, topical, transient improvement, urticaria, Clinical Sciences, Dermatology & Venereal Diseases, Clinical sciences
Abstract

Poor adherence to medication is a major public health challenge. Here, we aimed to determine the adherence to oral and topical medications and to analyze underlying associated factors using the translated Japanese version of Morisky Medication Adherence Scale-8 regarding urticaria treatment. Web-based questionnaires were performed for 3096 registered dermatological patients, along with a subanalysis of 751 registered urticaria patients in this study. The adherence to oral medication was significantly associated with the frequency of hospital visits. Variables that affected the adherence to topical medication included age and experience of drug effectiveness. The rate of responses that "It felt like the symptoms had improved" varied significantly among the dermatological diseases treated with oral medications. Dermatologists should be aware that adherence to the treatment of urticaria is quite low. Regular visits and active education for patients with urticaria are mandatory in order to achieve a good therapeutic outcome by increasing the adherence.

Published
2015

2. Characterization of socioeconomic status of Japanese patients with atopic dermatitis showing poor medical adherence and reasons for drug discontinuation

Author

Murota, Hiroyuki, Takeuchi, Satoshi, Sugaya, Makoto, Tanioka, Miki, Onozuka, Daisuke, Hagihara, Akihito, Saeki, Hidehisa, Imafuku, Shinichi, Abe, Masatoshi, Shintani, Yoichi, Kaneko, Sakae, Masuda, Koji, Hiragun, Takaaki, Inomata, Naoko, Kitami, Yuki, Tsunemi, Yuichiro, Abe, Shinya, Kobayashi, Miwa, Morisky, Donald E, Furue, Masutaka, and Katoh, Norihito

Subjects
Pharmacology and Pharmaceutical Sciences, Biomedical and Clinical Sciences, Clinical Research, Behavioral and Social Science, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, 7.1 Individual care needs, Management of diseases and conditions, Skin, Administration, Cutaneous, Administration, Oral, Adolescent, Adult, Aged, Aged, 80 and over, Alcohol Drinking, Dermatitis, Atopic, Dermatologic Agents, Employment, Female, Humans, Japan, Male, Marital Status, Medication Adherence, Middle Aged, Patient Satisfaction, Sex Factors, Surveys and Questionnaires, Treatment Outcome, Young Adult, Atopic dermatitis, Adherence, Morisky Medication Adherence Scale-8, Treatment satisfaction, Clinical Sciences, Dermatology & Venereal Diseases, Clinical sciences
Abstract

BackgroundPatients' high adherence to medication is indispensable for the management of skin diseases including atopic dermatitis. We previously showed poor medication adherence in Japanese dermatological patients.ObjectiveThis study was conducted to determine the level of adherence to oral or topical medication in Japanese patients with atopic dermatitis, attempting to characterize the socioeconomic status of those patients with poor adherence.MethodsA web questionnaire survey on demographic data as well as adherence level was conducted on patients registered in the monitoring system. Adherence level was assessed with Morisky Medication Adherence Scale-8 (MMAS-8). Among a total of 3096 respondents with dermatological disorders, data of 1327 subjects with atopic dermatitis were extracted and analyzed.ResultsMore than 80% of subjects felt that both oral and topical medications were safe and efficacious, while less than 60% of them were satisfied with their treatment. Levels of adherence to oral and topical treatments were evaluated with MMAS-8, giving scores of 4.6 and 4.2, respectively. Demographic factors such as gender, marital status, state of employment, alcohol consumption, frequency of hospital visits, and experience of drug effectiveness had a significant impact on the degree of adherence to treatment.ConclusionMedication adherence level in Japanese subjects with atopic dermatitis was relatively low compared with that of other chronic diseases. Our survey has characterized patients with poor adherence, who are good targets for interventions to maximize potentially limited healthcare resources.

Published
2015

3. Poor adherence to medication as assessed by the Morisky Medication Adherence Scale‐8 and low satisfaction with treatment in 237 psoriasis patients

Author

Saeki, Hidehisa, Imafuku, Shinichi, Abe, Masatoshi, Shintani, Yoichi, Onozuka, Daisuke, Hagihara, Akihito, Katoh, Norito, Murota, Hiroyuki, Takeuchi, Satoshi, Sugaya, Makoto, Tanioka, Miki, Kaneko, Sakae, Masuda, Koji, Hiragun, Takaaki, Inomata, Naoko, Kitami, Yuki, Tsunemi, Yuichiro, Abe, Shinya, Kobayashi, Miwa, Morisky, Donald E, and Furue, Masutaka

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Psoriasis, Clinical Research, 7.1 Individual care needs, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Management of diseases and conditions, Skin, Administration, Topical, Adult, Aged, Aged, 80 and over, Dermatologic Agents, Female, Humans, Japan, Male, Medication Adherence, Middle Aged, Patient Satisfaction, Skin Diseases, Surveys and Questionnaires, Young Adult, adherence, Morisky Medication Adherence Scale-8, psoriasis, sociomedical factor, treatment satisfaction, Dermatology & Venereal Diseases, Clinical sciences
Abstract

Previously we assessed the medication adherence for oral and topical remedies by a translated Japanese version of the Morisky Medication Adherence Scale-8 (MMAS-8) together with socioeconomic backgrounds in 3096 Japanese dermatological patients, and found the medication adherence, especially to topical drugs, was poor in these patients. In order to elucidate the disease-specific sociomedical factors, we further sub-analyzed the medication adherence in 237 psoriasis patients and compared it with that in other dermatological diseases such as atopic dermatitis, urticaria or tinea. This study was conducted among patients registered in monitoring system and 3096 eligible patients were enrolled. Our web-based questionnaire included the following items such as age, sex, annual income, main health-care institution, experience of effectiveness by oral or topical medication, overall satisfaction with treatment, and MMAS-8 for oral or topical medication. Mean adherence score by MMAS-8 was 5.2 for oral and 4.3 for topical medication. More patients with psoriasis used a university hospital and fewer used a private clinic compared with those with the other skin disease patients. Experience of drug effectiveness by oral medication and overall satisfaction with treatment was lower in psoriasis patients than in other patients. In oral medication, significantly better adherence was observed in those of higher age and with higher annual income. The adherence to medication, especially to topical drugs, was poor in 237 psoriasis patients. We speculated that some severe psoriasis patients were not sufficiently treated systemically and were resistant to topical therapy, leading to poor adherence.

Published
2015

4. The global impact of the COVID-19 pandemic on the management and course of chronic urticaria

Author

Kocatürk, Emek, Salman, Andaç, Cherrez-Ojeda, Ivan, Criado, Paulo Ricardo, Peter, Jonny, Comert-Ozer, Elif, Abuzakouk, Mohamed, Câmara Agondi, Rosana, Al-Ahmad, Mona, Altrichter, Sabine, Arnaout, Rand, Arruda, Luisa Karla, Asero, Riccardo, Bauer, Andrea, Ben-Shoshan, Moshe, Bernstein, Jonathan, Bizjak, Mojca, Boccon-Gibod, Isabelle, Bonnekoh, Hanna, Bouillet, Laurence, Brzoza, Zenon, Busse, Paula, Campos, Regis A., Carne, Emily, Conlon, Niall, Criado, Roberta Fachini Jardim, De Souza Lima, Eduardo Magalhães, Demir, Semra, Dissemond, Joachim, Doğan Günaydın, Sibel, Dorofeeva, Irina, Ensina, Luis Felipe, Ertaş, Ragip, Ferrucci, Silvia Mariel, Figueras-Nart, Ignasi, Fomina, Daria, Franken, Sylvie M., Fukunaga, Atsushi, Giménez Arnau, Ana M, Godse, Kiran, Gonçalo, Margarida, Gotua, Maia, Grattan, Clive, Guillet, Carole, Inomata, Naoko, Jakob, Thilo, Karakaya, Gul, Kasperska-Zając, Alicja, Katelaris, Constance H., Košnik, Mitja, Krasowska, Dorota, Kulthanan, Kanokvalai, Kumaran, M.Sendhil, Lang, Claudia, Larco-Sousa, José Ignacio, Lazaridou, Elisavet, Leslie, Tabi Anika, Lippert, Undine, Calderón llosa, Oscar, Makris, Michael, Marsland, Alexander, Medina, Iris V., Meshkova, Raisa, Bastos Palitot, Esther, Parisi, Claudio A.S., Pickert, Julia, Ramon, Germán D., Rodríguez-Gonzalez, Mónica, Rosario, Nelson, Rudenko, Michael, Rutkowski, Krzysztof, Sánchez Caraballo, Jorge Mario, Schliemann, Sibylle, Sekerel, Bulent Enis, Serpa, Faradiba S., Serra-Baldrich, E, Song, Zhiqiang, Soria, Angèle, Staevska, Maria, Staubach, Petra, Tagka, Anna, Takahagi, Shunsuke, Thomsen, Simon Francis, Treudler, Regina, Vadasz, Zahava, Rodrigues Valle, Solange Oliveira, Van Doorn, Martijn B.A., Vestergaard, Christian, Wagner, Nicola, Wang, Dahu, Wang, Liangchun, Wedi, Bettina, Xepapadaki, Paraskevi, Yücel, Esra, Zalewska-Janowska, Anna, Zhao, Zuotao, Zuberbier, Torsten, Maurer, Marcus, Universitat Autònoma de Barcelona, Dermatology, Göncü, Özgür Emek Kocatürk (ORCID 0000-0003-2801-0959 & YÖK ID 217219), Salman, A., Cherrez-Ojeda, I., Criado, P. R., Peter, J., Comert-Ozer, E., Abuzakouk, M., Agondi, R. C., Al-Ahmad, M., Altrichter, S., Arnaout, R., Arruda, L. K., Asero, R., Bauer, A., Ben-Shoshan, M., Bernstein, J. A., Bizjak, M., Boccon-Gibod, I., Bonnekoh, H., Bouillet, L., Brzoza, Z., Busse, P., Campos, R. A., Carne, E., Conlon, N., Criado, R. F., Lima, E. M. D., Demir, S., Dissemond, J., Gunaydin, S. D., Dorofeeva, I., Ensina, L. F., Ertas, R., Ferrucci, S. M., Figueras-Nart, I., Fomina, D., Franken, S. M., Fukunaga, A., Gimenez-Arnau, A. M., Godse, K., Goncalo, M., Gotua, M., Grattan, C., Guillet, C., Inomata, N., Jakob, T., Karakaya, G., Kasperska-Zajac, A., Katelaris, C. H., Kosnik, M., Krasowska, D., Kulthanan, K., Kumaran, M. S., Lang, C., Larco-Sousa, J. I., Lazaridou, E., Leslie, T. A., Lippert, U., Llosa, O. C., Makris, M., Marsland, A., Medina, I. V., Meshkova, R., Palitot, E. B., Parisi, C. A. S., Pickert, J., Ramon, G. D., Rodriguez-Gonzalez, M., Rosario, N., Rudenko, M., Rutkowski, K., Sanchez, J., Schliemann, S., Sekerel, B. E., Serpa, F. S., Serra-Baldrich, E., Song, Z. Q., Soria, A., Staevska, M., Staubach, P., Tagka, A., Takahagi, S., Thomsen, S. F., Treudler, R., Vadasz, Z., Valle, S. O. R., Van Doorn, M. B. A., Vestergaard, C., Wagner, N., Wang, D. H., Wang, L. C., Wedi, B., Xepapadaki, P., Yücel, E., Zalewska-Janowska, A., Zhao, Z. T., Zuberbier, T., Maurer, M., School of Medicine, AII - Infectious diseases, Kocaturk, Emek, Salman, Andac, Cherrez-Ojeda, Ivan, Criado, Paulo Ricardo, Peter, Jonny, Comert-Ozer, Elif, Abuzakouk, Mohamed, Agondi, Rosana Camara, Al-Ahmad, Mona, Altrichter, Sabine, Arnaout, Rand, Arruda, Luisa Karla, Asero, Riccardo, Bauer, Andrea, Ben-Shoshan, Moshe, Bernstein, Jonathan A., Bizjak, Mojca, Boccon-Gibod, Isabelle, Bonnekoh, Hanna, Bouillet, Laurence, Brzoza, Zenon, Busse, Paula, Campos, Regis A., Carne, Emily, Conlon, Niall, Criado, Roberta F., de Souza Lima, Eduardo M., Demir, Semra, Dissemond, Joachim, Gunaydin, Sibel Dogan, Dorofeeva, Irina, Ensina, Luis Felipe, Ertas, Ragip, Ferrucci, Silvia Mariel, Figueras-Nart, Ignasi, Fomina, Daria, Franken, Sylvie M., Fukunaga, Atsushi, Gimenez-Arnau, Ana M., Godse, Kiran, Goncalo, Margarida, Gotua, Maia, Grattan, Clive, Guillet, Carole, Inomata, Naoko, Jakob, Thilo, Karakaya, Gul, Kasperska-Zajac, Alicja, Katelaris, Constance H., Kosnik, Mitja, Krasowska, Dorota, Kulthanan, Kanokvalai, Kumaran, M. Sendhil, Lang, Claudia, Ignacio Larco-Sousa, Jose, Lazaridou, Elisavet, Leslie, Tabi Anika, Lippert, Undine, Llosa, Oscar Calderon, Makris, Michael, Marsland, Alexander, Medina, Iris, V, Meshkova, Raisa, Palitot, Esther Bastos, Parisi, Claudio A. S., Pickert, Julia, Ramon, German D., Rodriguez-Gonzalez, Monica, Rosario, Nelson, Rudenko, Michael, Rutkowski, Krzysztof, Sanchez, Jorge, Schliemann, Sibylle, Sekerel, Bulent Enis, Serpa, Faradiba S., Serra-Baldrich, Esther, Song, Zhiqiang, Soria, Angele, Staevska, Maria, Staubach, Petra, Tagka, Anna, Takahagi, Shunsuke, Thomsen, Simon Francis, Treudler, Regina, Vadasz, Zahava, Rodrigues Valle, Solange Oliveira, Van Doorn, Martijn B. A., Vestergaard, Christian, Wagner, Nicola, Wang, Dahu, Wang, Liangchun, Wedi, Bettina, Xepapadaki, Paraskevi, Yucel, Esra, Zalewska-Janowska, Anna, Zhao, Zuotao, Zuberbier, Torsten, and Maurer, Marcus

Subjects
Male, 0301 basic medicine, STRESS, Exacerbation, UCARE, pandemije, Medizin, Omalizumab, SERUM, chronic urticaria, 0302 clinical medicine, Pandemic, Health care, Immunology and Allergy, Chronic Urticaria, treatment, Chronic urticaria, COVID-19, Cyclosporine, SARS-CoV-2, Treatment, zdravljenje, ASSOCIATION, Middle Aged, cyclosporine, omalizumab, pandemic, kronična urtikarija, INFECTIONS, GA(2)LEN, Female, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit, medicine.drug, Adult, medicine.medical_specialty, Adolescent, Coronavirus disease 2019 (COVID-19), Immunology, udc:616-097, pandemics, ciklosporin, Young Adult, 03 medical and health sciences, Patient referral, medicine, Humans, In patient, Patient Reported Outcome Measures, Aged, Internet, business.industry, DEFINITION, Medicine, Allergy, Cross-Sectional Studies, 030104 developmental biology, 030228 respiratory system, Emergency medicine, business
Abstract

Introduction: the COVID-19 pandemic dramatically disrupts health care around the globe. The impact of the pandemic on chronic urticaria (CU) and its management are largely unknown. Aim: to understand how CU patients are affected by the COVID-19 pandemic; how specialists alter CU patient management; and the course of CU in patients with COVID-19. Materials and methods: our cross-sectional, international, questionnaire-based, multicenter UCARE COVID-CU study assessed the impact of the pandemic on patient consultations, remote treatment, changes in medications, and clinical consequences. Results: the COVID-19 pandemic severely impairs CU patient care, with less than 50% of the weekly numbers of patients treated as compared to before the pandemic. Reduced patient referrals and clinic hours were the major reasons. Almost half of responding UCARE physicians were involved in COVID-19 patient care, which negatively impacted on the care of urticaria patients. The rate of face-to-face consultations decreased by 62%, from 90% to less than half, whereas the rate of remote consultations increased by more than 600%, from one in 10 to more than two thirds. Cyclosporine and systemic corticosteroids, but not antihistamines or omalizumab, are used less during the pandemic. CU does not affect the course of COVID-19, but COVID-19 results in CU exacerbation in one of three patients, with higher rates in patients with severe COVID-19. Conclusions: the COVID-19 pandemic brings major changes and challenges for CU patients and their physicians. The long-term consequences of these changes, especially the increased use of remote consultations, require careful evaluation., Novartis; Sanofi; Menarini Universidad Espiritu Santo; Takeda; Allakos; AstraZeneca; CSL Behring; Genentech; Pharming; GSK; Shire/Takada; BioCryst; ResTORbio; Pearl Therapeutics, CVS Health; Law offices of Levin; Riback; Adelman; Flangel; Vedder Price; Fresenius; Taiho; Kyowa Kirin; Tanabe; Korin; Uriach Pharma; Instituto Carlos III FEDER; Menarini; Amgen; Thermo Fisher; Avene; ALK‐Abello; Bencard/Allergy Therapeutics; Celgene; Allergopharma; Faes Farma; AbbVie; Janssen; Leo Pharma; Lilly; Roche; Genesis; Menlo Therapeutics; UCB; Pfizer; Almirall; Galderma; Allergika; Beiersdorf; Biocryst; Biogen Idec; BMS; Boehringer‐Ingelheim; Eli‐Lilly; Galderma; Hexal; Klosterfrau; LEO‐Pharma; LETI‐Pharma; L´Oreal; Medice; Octapharma; Pflüger; Pharming; Regeneron; Shire; ALK‐Abello; Fraunhofer‐IZI Leipzig; Hautnetz Leipzig/Westsachsen; MSD; HAL‐Allergy; Bencard; Nestle; Nutricia; Bayer Health Care; FAES; Henkel; Allakos; Argenx; Genentech Menarini; Moxie; Aralez; Celldex

Published
2021
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5. Efficacy and safety of omalizumab in Japanese and Korean patients with refractory chronic spontaneous urticaria

Author

Michihiro, Hide, Hae-Sim, Park, Atsuyuki, Igarashi, Young-Min, Ye, Tae-Bum, Kim, Akiko, Yagami, Jooyoung, Roh, Jae-Hyun, Lee, Yuko, Chinuki, Woong, Youn Sang, Hide, Michihiro, Park, Hae-Sim, Igarashi, Atsuyuki, Ye, Young-Min, Kim, Tae-Bum, Yagami, Akiko, Roh, Jooyoung, Lee, Jae-Hyun, Chinuki, Yuko, Youn, Woong Sang, Lee, Soo-Keol, Inomata, Naoko, Choi, Jeong-Hee, Fukunaga, Atsushi, Wang, Junyi, Matsushima, Soichiro, Greenberg, Steve, and Khalil, Sam

Subjects
Adult, Male, medicine.medical_specialty, Urticaria, Dermatology, Omalizumab, Placebo, Biochemistry, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Refractory, Quality of life, Double-Blind Method, Japan, Internal medicine, medicine, Humans, Antihistamines, Chronic spontaneous urticaria, Korea, Adverse effect, Molecular Biology, business.industry, Dermatology Life Quality Index, Middle Aged, 030228 respiratory system, Chronic Disease, Asian population, Physical therapy, Female, business, Body mass index, medicine.drug
Abstract

Background: Many patients with chronic spontaneous/idiopathic urticaria (CSU/CIU) do not respond adequately to treatment with non-sedating H1 antihistamines (H1AH). There are limited studies on use of omalizumab as add-on therapy for treatment of CSU in an Asian population. Objective: The POLARIS study (NCT02329223), representing the first randomized, double-blind, placebo controlled phase III trial of omalizumab for CSU in an Eastern Asian population, evaluated efficacy and safety of omalizumab as add-on therapy for treatment of CSU. Methods: This 26-week multicenter (41 Japanese/Korean sites) study enrolled patients (12-75 years) who were symptomatic despite H1AH treatment. Eligible participants (N = 218) were randomized 1:1:1 to receive three subcutaneous injections of omalizumab 300 mg, 150 mg, or placebo every 4 weeks, followed by 12 weeks of follow-up. Primary outcome was change from baseline to Week 12 (Wk12) in weekly itch severity score (ISS7). Safety was assessed through the summary of adverse events (AEs). Results: Baseline demographics and disease characteristics were generally well balanced across treatment groups. At Wk12, statistically significant decreases from baseline were observed in ISS7 with omalizumab vs placebo (mean changes -10.22, -8.80, and -6.51 for omalizumab 300 mg, 150 mg and placebo; p < 0.001 and p = 0.006 vs placebo, respectively). Overall AE incidence was similar across treatment groups (54.8%, 57.7%, and 55.4% in omalizumab 300 mg, 150 mg, and placebo groups, respectively); nasopharyngitis was the most frequently reported AE in all treatment arms. Conclusion: The POLARIS study demonstrates that omalizumab is an efficacious and well-tolerated add-on therapy in Japanese and Korean H1AH-refractory patients with CSU.

Published
2017

6. Risk factors for systemic reactions in typical cold urticaria: Results from the COLD-CE study

Author

Emek Kocatürk, Ana Giménez-Arnau, Roberta Fachini Jardim Criado, David Pesqué, Maria Pasali, Solange Oliveira Rodrigues Valle, Simon Francis Thomsen, Mitja Košnik, Daria Fomina, Aliya Klyucharova, Célia Costa, Dejan Dinevski, Rongbiao Lu, Luis Felipe Ensina, Paraskevi Xepapadaki, Michael Makris, Sabine Altrichter, Maryam Khoshkhui, Naoko Inomata, Dalia Melina Ahsan, Elena Borzova, Maxi Brockstädt, Andrea Bauer, German D. Ramon, Xiaoyang Xue, Eduardo Magalhães de Souza Lima, Zuotao Zhao, Kanokvalai Kulthanan, Dorothea Terhorst-Molawi, Jesper Grønlund Holm, Mona Al-Ahmad, Jovan Miljković, Marisa Paulino, Margarida Gonçalo, Semra Demir, Alicja Kasperska-Zajac, Agnieszka Sikora, Jonny Peter, M. Gotua, Natalya Maltseva, Michael Rudenko, Marcus Maurer, Mojca Bizjak, Carla Ritchie, Aslı Gelincik, Raisa Meshkova, Nicola Wagner, Publica, Göncü, Özgür Emek Kocatürk (ORCID 0000-0003-2801-0959 & YÖK ID 217219), Bizjak, Mojca, Kosnik, Mitja, Dinevski, Dejan, Thomsen, Simon Francis, Fomina, Daria, Borzova, Elena, Kulthanan, Kanokvalai, Meshkova, Raisa, Ahsan, Dalia Melina, Al-Ahmad, Mona, Altrichter, Sabine, Bauer, Andrea, Brockstadt, Maxi, Costa, Celia, Demir, Semra, Criado, Roberta Fachini, Ensina, Luis Felipe, Gelincik, Aslı, Gimenez-Arnau, Ana Maria, Goncalo, Margarida, Gotua, Maia, Holm, Jesper Gronlund, Inomata, Naoko, Kasperska-Zajac, Alicja, Khoshkhui, Maryam, Klyucharova, Aliya, Lu, Rongbiao, Makris, Michael, Maltseva, Natalya, Miljkovic, Jovan, Pasali, Maria, Paulino, Marisa, Pesque, David, Peter, Jonny, Ramon, German Dario, Ritchie, Carla, Valle, Solange Oliveira Rodrigues, Rudenko, Michael, Sikora, Agnieszka, Lima, Eduardo M. Souza, Wagner, Nicola, Xepapadaki, Paraskevi, Xue, Xiaoyang, Zhao, Zuotao, Terhorst-Molawi, Dorothea, Maurer, Marcus, and School of Medicine

Subjects
medicine.medical_specialty, Urticaria, adrenaline autoinjector, Immunology, systemic reactions, Cold urticaria, Autoinjector, Risk Factors, medicine, risk factors, Immunology and Allergy, Animals, Humans, Chronic Urticaria, Angioedema, Adrenaline autoinjector, COLD-CE, Risk factors, Systemic reactions, Allergy, business.industry, Pruritus, Cold air, Insect Bites and Stings, medicine.disease, Dermatology, Hymenoptera, cold urticaria, Cold Temperature, Sting, Systemic reaction, Cross-Sectional Studies, Concomitant, medicine.symptom, business, Anaphylaxis, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
Abstract

Background: cold urticaria (ColdU), that is, the occurrence of wheals or angioedema in response to cold exposure, is classified into typical and atypical forms. The diagnosis of typical ColdU relies on whealing in response to local cold stimulation testing (CST). It can also manifest with cold-induced anaphylaxis (ColdA). We aimed to determine risk factors for ColdA in typical ColdU. Methods: an international, cross-sectional study COLD-CE was carried out at 32 urticaria centers of reference and excellence (UCAREs). Detailed history was taken and CST with an ice cube and/or TempTest(R) performed. ColdA was defined as an acute cold-induced involvement of the skin and/or visible mucosal tissue and at least one of: cardiovascular manifestations, difficulty breathing, or gastrointestinal symptoms. Results: of 551 ColdU patients, 75% (n = 412) had a positive CST and ColdA occurred in 37% (n = 151) of the latter. Cold-induced generalized wheals, angioedema, acral swelling, oropharyngeal/laryngeal symptoms, and itch of earlobes were identified as signs/symptoms of severe disease. ColdA was most commonly provoked by complete cold water immersion and ColdA caused by cold air was more common in countries with a warmer climate. Ten percent (n = 40) of typical ColdU patients had a concomitant chronic spontaneous urticaria (CSU). They had a lower frequency of ColdA than those without CSU (4% vs. 39%, p = .003). We identified the following risk factors for cardiovascular manifestations: previous systemic reaction to a Hymenoptera sting, angioedema, oropharyngeal/laryngeal symptoms, and itchy earlobes. Conclusion: coldA is common in typical ColdU. High-risk patients require education about their condition and how to use an adrenaline autoinjector., GA(2)LEN UCARE Network

Published
2021
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