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首页> 美国卫生研究院文献>Journal of Asthma and Allergy >Management of Pediatric Chronic Spontaneous Urticaria: A Review of Current Evidence and Guidelines
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Management of Pediatric Chronic Spontaneous Urticaria: A Review of Current Evidence and Guidelines

机译：小儿慢性自发性荨麻疹的管理：审查当前证据和指导方针

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Chronic urticaria (CU) is associated with debilitating symptoms such as pruritic wheals and/or angioedema, which can significantly affect patients’ sleep, productivity and quality of life. Chronic spontaneous urticaria (CSU) is defined in cases in which no triggering factor is identified. Various guidelines directing the optimal management of CU in the adult population were published and updated over the recent years with the most accepted and widely used being the EAACI/GA2LEN/EDF/WAO 2017 guidelines. Meanwhile, guidelines specific to the pediatric population are scarce, mainly due to the fact that high quality evidence is lacking for many treatment options in this age group. The objective of this article is to review and synthesize the existing literature regarding the management of pediatric CSU. Our review highlights evidence supporting the EAACI/GA2LEN/EDF/WAO 2017 treatment guidelines with non-sedating second-generation antihistamines (sgAHs) as the mainstay of treatment for pediatric CSU, considering their demonstrated efficacy and reassuring safety profile. Additionally, the use of omalizumab in adolescents is well supported by the current literature. There is limited data available regarding the updosing of sgAHs, omalizumab in children with CSU under 12 years of age and the treatment with cyclosporine and leukotriene receptor antagonists (LTRAs) in pediatric patients of all ages. However, the results from currently available case series and case reports are promising for omalizumab and cyclosporine use in children with CSU, although large and well-designed randomized control trials (RCTs) assessing these treatment options are needed in order to formulate strong recommendations for their use. First-generation antihistamines (fgAHs) remain commonly used in pediatric CSU treatment despite a lack of studies assessing their efficacy and safety in the pediatric population and their widely known inferior safety profile compared to sgAHs.
机译：慢性荨麻疹（Cu）与衰弱的症状有关，例如瘙痒症和/或血管血清，这可以显着影响患者的睡眠，生产力和生活质量。在没有识别触发因子的情况下定义慢性自发性荨麻疹（CSU）。在近年来，在近年来，近年来，各种指导指示Cu在成人人口中的最佳管理，最受欢迎和广泛使用的是EACI / GA2LEN / EDF / WAO 2017指南。同时，特定于儿科人口的准则是稀缺的，主要是由于这个年龄组中许多治疗方案缺乏高质量证据。本文的目标是审查和综合关于儿科CSU的管理的现有文献。我们的评论强调了支持EAACI / GA2LEN / EDF / IDF / WAO 2017治疗指南的证据，其具有非镇静第二代抗组胺药（SGAH）作为儿科CSU的待遇的主干，考虑到他们所示的疗效和令人放心的安全性。此外，在当前文献中，在青少年中使用omalizumab是很好的支持。有限的数据可提供有关在12岁以下CSU的SGAH，Omalizumab中的数据提供，并且在所有年龄段的儿科患者中使用环孢菌素和白孢菌素受体拮抗剂（LTRAS）。然而，目前可用案例系列和案例报告的结果对于CSU的儿童对omalizumab和Cyclosporine使用具有对CSU的儿童使用的，尽管需要大型且设计精心设计的随机控制试验（RCT），以适应他们的强烈建议用。尽管缺乏评估儿科人群的疗效和安全性，但与SGAH相比，第一代抗组胺药（FGAHS）仍然用于儿科CSU治疗常用于儿科CSU治疗。

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