Chronic urticaria treatment challenges in children

Area of Science:

• Pediatric Dermatology
• Allergy and Immunology
• Pharmacology

Background:

• Chronic urticaria (CU) presents unique challenges in pediatric populations.
• Limited research exists on effective and safe CU treatments specifically for children.
• Assessing treatment outcomes in children requires age-appropriate patient-reported outcome measures (PROMs).

Purpose of the Study:

• To review the efficacy and safety of current chronic urticaria treatments in children.
• To evaluate patient-reported outcome measures (PROMs) utilized for pediatric CU.
• To inform clinical guidelines and future research for pediatric CU management.

Main Methods:

• A non-systematic review of published articles from the last decade.
• Searched PubMed using keywords related to CU treatments and pediatric populations.
• Included studies in English, Spanish, and Portuguese.

Main Results:

• High-dose antihistamines demonstrate effectiveness (35-92% control) with limited safety data in children.
• Omalizumab shows high efficacy (>80% symptom control) and safety in pediatric CU, including off-label use.
• Cyclosporine exhibits good response rates with few adverse events in pediatric CU.
• Validated PROMs like UAS7, UCT, and CUQoL are valuable for clinical decision-making.

Conclusions:

• Current treatments like antihistamines, omalizumab, and cyclosporine are generally safe and effective for pediatric CU with dose adjustments.
• Further collaborative studies are needed to strengthen evidence supporting guideline recommendations for children.
• Validated PROMs are crucial for comprehensive assessment and management of pediatric chronic urticaria.