The EAACI/GA²LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria

Allergy: European Journal of Allergy and Clinical Immunology

Volumn 73, Issue 7, 2018, Pages 1393-1414

  Zuberbier, T ^a   Aberer, W ^b   Asero, R ^c   Abdul Latiff, A H ^d   Baker, D ^e   Ballmer Weber, B ^f   Bernstein, J A ^g   Bindslev Jensen, C ^h   Brzoza, Z ⁱ   Buense Bedrikow, R ^j   Canonica, G W ^k   Church, M K ^a   Craig, T ^l   Danilycheva, I V ^m   Dressler, C ^a   Ensina, L F ⁿ   Gimenez Arnau A ^o   Godse, K ^p   Goncalo M ^q   Grattan, C ^r   Hebert, J ^s   Hide, M ^t   Kaplan, A ^u   Kapp, A ^v   Katelaris, C H ^w   Kocaturk E ^x   Kulthanan, K ^y   Larenas Linnemann, D ^z   Leslie, T A ^aa   Magerl, M ^a   Mathelier Fusade, P ^ab   Meshkova, R Y ^ac   Metz, M ^a   Nast, A ^a   Nettis, E ^ad   Oude Elberink, H ^ae   Rosumeck, S ^a   Saini, S S ^af   Sanchez Borges M ^ag   Schmid Grendelmeier, P ^f   Staubach, P ^ah   Sussman, G ^ai   Toubi, E ^aj   Vena, G A ^ak   Vestergaard, C ^al   Wedi, B ^v   Werner, R N ^a   Zhao, Z ^am   Maurer, M ^a   more..

^a BERLIN INSTITUTE OF HEALTH   (Germany)

^b MEDICAL UNIVERSITY OF GRAZ   (Austria)

^c Clinica San Carlo   (Italy)

^d Pantai Medical Centre   (Malaysia)

^e Baker Allergy Asthma and Dermatology Clinic   (United States)

^f UNIVERSITY HOSPITAL ZURICH   (Switzerland)

^g UNIVERSITY OF CINCINNATI   (United States)

^h UNIVERSITY OF SOUTHERN DENMARK   (Denmark)

ⁱ MEDICAL UNIVERSITY OF SILESIA   (Poland)

^j Medical Sciences School of Santa Casa de Sao Paulo   (Brazil)

^k HUMANITAS CLINICAL AND RESEARCH CENTER   (Italy)

^l PENN STATE MILTON S HERSHEY MEDICAL CENTER   (United States)

^m INSTITUTE OF IMMUNOLOGY   (Russian Federation)

ⁿ FEDERAL UNIVERSITY OF SÃO PAULO   (Brazil)

^o UNIVERSITAT AUTÒNOMA DE BARCELONA   (Spain)

^p Padmashree Dr DY Patil Medical College   (India)

^q UNIVERSITY OF COIMBRA   (Portugal)

^r ST THOMAS HOSPITAL   (United Kingdom)

^s LAVAL UNIVERSITY   (Canada)

^t HIROSHIMA UNIVERSITY   (Japan)

^u MEDICAL UNIVERSITY OF SOUTH CAROLINA   (United States)

^v HANNOVER MEDICAL SCHOOL   (Germany)

^w UNIVERSITY OF WESTERN SYDNEY   (Australia)

^x OKMEYDANI TRAINING AND RESEARCH HOSPITAL   (Turkey)

^y MAHIDOL UNIVERSITY   (Thailand)

^z Hospital Medica Sur   (Mexico)

^aa ROYAL FREE HOSPITAL   (United Kingdom)

^ab HÔPITAL TENON   (France)

^ac SMOLENSK STATE MEDICAL UNIVERSITY   (Russian Federation)

^ad UNIVERSITY OF BARI   (Italy)

^ae UNIVERSITY OF GRONINGEN   (Netherlands)

^af JOHNS HOPKINS ASTHMA AND ALLERGY CENTER   (United States)

^ag Centro Medico Docente La Trinidad   (Venezuela)

^ah UNIVERSITY MEDICAL CENTER MAINZ   (Germany)

^ai UNIVERSITY OF TORONTO   (Canada)

^aj BNAI ZION MEDICAL CENTER   (Israel)

^ak Dermatology and Venereology Private Practice   (Italy)

^al AARHUS UNIVERSITY HOSPITAL   (Denmark)

^am PEKING UNIVERSITY   (China)

more..

Author keywords

angioedema; consensus; evidence based; hives; wheal

Indexed keywords

ANTIHISTAMINIC AGENT;

ACADEMIC ACHIEVEMENT; ACUTE DISEASE; ALLERGIC ASTHMA; ARTICLE; CHRONIC URTICARIA; CLINICAL IMMUNOLOGY; DERMATOLOGY; DIETARY INTAKE; DISEASE ACTIVITY; DISEASE BURDEN; DISEASE CLASSIFICATION; EMOTIONAL STRESS; EUROPEAN UNION; EVIDENCE BASED PRACTICE; HEALTH CARE ORGANIZATION; HUMAN; INFECTIOUS AGENT; INFLAMMATION; JOB PERFORMANCE; LACTATION; MEDICAL SPECIALIST; PHYSICAL STIMULATION; PHYSICAL STRESS; PRACTICE GUIDELINE; PREGNANT WOMAN; PREVALENCE; PRIORITY JOURNAL; URTICARIA; DISEASE MANAGEMENT; EUROPE; HEALTH SERVICE; RESEARCH;

DISEASE MANAGEMENT; EUROPE; HEALTH SERVICES NEEDS AND DEMAND; HUMANS; RESEARCH; URTICARIA;

EID: 85048001207     PISSN: 01054538     EISSN: 13989995     Source Type: Journal    
DOI: 10.1111/all.13397     Document Type: Article

References (168)

1. Zuberbier T, Asero R, Bindslev-Jensen C, et al. EAACI/GA(2)LEN/EDF/WAO guideline: definition, classification and diagnosis of urticaria. Allergy 2009;64:1417-1426.
2. Zuberbier T, Asero R, Bindslev-Jensen C, et al. EAACI/GA(2)LEN/EDF/WAO guideline: management of urticaria. Allergy 2009;64:1427-1443.
3. Zuberbier T, Aberer W, Asero R, et al. The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update. Allergy 2014;69:868-887.
4. Zuberbier T, Aberer W, Asero R, et al. Methods report on the development of the 2013 revision and update of the EAACI/GA2 LEN/EDF/WAO guideline for the definition, classification, diagnosis, and management of urticaria. Allergy 2014;69:e1-29.
5. Dressler C, Rosumeck S, Werner RN, Magerl M, Metz M, Maurer M, Nast A, Zuberbier T. Executive summary: methods and evidence report for the evidence- and consensus-based (S3) Guideline for the definition, classification, diagnosis, and management of urticaria - revision and update 2017. Allergy. 2018;73:1145-1146.
6. AGREE Next Steps Consortium. The AGREE II Instrument; 2009. http://www.agreetrust.org/. Accessed January 12, 2015.
7. Higgins JPT, Green S, Cochrane C. Cochrane handbook for systematic reviews of interventions; 2011. http://www.cochrane-handbook.org/
8. Guyatt GH, Oxman AD, Kunz R, et al. GRADE guidelines: 2. Framing the question and deciding on important outcomes. J Clin Epidemiol 2011;64:395-400.
9. Finlay AY, Kaplan AP, Beck LA, et al. Omalizumab substantially improves dermatology-related quality of life in patients with chronic spontaneous urticaria. J Eur Acad Dermatol Venereol 2017;31:1715-1721.
10. Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ 2004;328:1490.
11. GRADEpro GDT: GRADEpro Guideline Development Tool. McMaster University (developed by Evidence Prime, Inc.); 2015.
12. Jones J, Hunter D. Consensus methods for medical and health services research. BMJ 1995;311:376-380.
13. Haas N, Schadendorf D, Henz BM. Differential endothelial adhesion molecule expression in early and late whealing reactions. Int Arch Allergy Immunol 1998;115:210-214.
14. Peteiro C, Toribio J. Incidence of leukocytoclastic vasculitis in chronic idiopathic urticaria. Study of 100 cases. Am J Dermatopathol 1989;11:528-533.
15. Ito Y, Satoh T, Takayama K, Miyagishi C, Walls AF, Yokozeki H. Basophil recruitment and activation in inflammatory skin diseases. Allergy 2011;66:1107-1113.
16. Kay AB, Clark P, Maurer M, Ying S. Elevations in T-helper-2-initiating cytokines (interleukin-33, interleukin-25 and thymic stromal lymphopoietin) in lesional skin from chronic spontaneous (‘idiopathic’) urticaria. Br J Dermatol 2015;172:1294-1302.
17. Kay AB, Ying S, Ardelean E, et al. Calcitonin gene-related peptide and vascular endothelial growth factor are expressed in lesional but not uninvolved skin in chronic spontaneous urticaria. Clin Exp Allergy 2014;44:1053-1060.
18. Zuberbier T, Schadendorf D, Haas N, Hartmann K, Henz BM. Enhanced P-selectin expression in chronic and dermographic urticaria. Int Arch Allergy Immunol 1997;114:86-89.
19. Kay AB, Ying S, Ardelean E, et al. Elevations in vascular markers and eosinophils in chronic spontaneous urticarial weals with low-level persistence in uninvolved skin. Br J Dermatol 2014;171:505-511.
20. Greaves MW. Chronic urticaria. N Engl J Med 1995;332:1767-1772.
21. Kaplan AP. Clinical practice. Chronic urticaria and angioedema. N Engl J Med 2002;346:175-179.
22. Hermes B, Prochazka AK, Haas N, Jurgovsky K, Sticherling M, Henz BM. Upregulation of TNF-alpha and IL-3 expression in lesional and uninvolved skin in different types of urticaria. J Allergy Clin Immunol 1999;103:307-314.
23. Maurer M, Weller K, Bindslev-Jensen C, et al. Unmet clinical needs in chronic spontaneous urticaria. A GA(2)LEN task force report. Allergy 2011;66:317-330.
24. Baiardini I, Braido F, Bindslev-Jensen C, et al. Recommendations for assessing patient-reported outcomes and health-related quality of life in patients with urticaria: a GA(2) LEN taskforce position paper. Allergy 2011;66:840-844.
25. Maurer M, Staubach P, Raap U, et al. H1-antihistamine-refractory chronic spontaneous urticaria: it's worse than we thought – first results of the multicenter real-life AWARE study. Clin Exp Allergy 2017;47:684-692.
26. Maurer M, Staubach P, Raap U, Richter-Huhn G, Baier-Ebert M, Chapman-Rothe N. ATTENTUS, a German online survey of patients with chronic urticaria highlighting the burden of disease, unmet needs and real-life clinical practice. Br J Dermatol 2016;174:892-894.
27. Maurer M, Abuzakouk M, Berard F, et al. The burden of chronic spontaneous urticaria is substantial: real-world evidence from ASSURE-CSU. Allergy 2017;72:2005-2016.
28. O'Donnell BF, Lawlor F, Simpson J, Morgan M, Greaves MW. The impact of chronic urticaria on the quality of life. Br J Dermatol 1997;136:197-201.
29. Baiardini I, Giardini A, Pasquali M, et al. Quality of life and patients’ satisfaction in chronic urticaria and respiratory allergy. Allergy 2003;58:621-623.
30. Parisi CA, Ritchie C, Petriz N, Morelo Torres C. Direct medical costs of chronic urticaria in a private health organization of Buenos Aires, Argentina. Value Health Reg Issues 2016;11:57-59.
31. Broder MS, Raimundo K, Antonova E, Chang E. Resource use and costs in an insured population of patients with chronic idiopathic/spontaneous urticaria. Am J Clin Dermatol 2015;16:313-321.
32. Graham J, McBride D, Stull D, et al. Cost utility of omalizumab compared with standard of care for the treatment of chronic spontaneous urticaria. Pharmacoeconomics 2016;34:815-827.
33. Zuberbier T, Maurer M. Urticaria: current opinions about etiology, diagnosis and therapy. Acta Derm Venereol 2007;87:196-205.
34. Kolkhir P, Church MK, Weller K, Metz M, Schmetzer O, Maurer M. Autoimmune chronic spontaneous urticaria: what we know and what we do not know. J Allergy Clin Immunol 2017;139:1772-1781.
35. Asero R, Tedeschi A, Marzano AV, Cugno M. Chronic urticaria: a focus on pathogenesis. F1000Res 2017;6:1095.
36. Kolkhir P, Balakirski G, Merk HF, Olisova O, Maurer M. Chronic spontaneous urticaria and internal parasites–a systematic review. Allergy 2016;71:308-322.
37. Imbalzano E, Casciaro M, Quartuccio S, et al. Association between urticaria and virus infections: a systematic review. Allergy Asthma Proc 2016;37:18-22.
38. Minciullo PL, Cascio A, Barberi G, Gangemi S. Urticaria and bacterial infections. Allergy Asthma Proc 2014;35:295-302.
39. Foti C, Nettis E, Cassano N, Di Mundo I, Vena GA. Acute allergic reactions to Anisakis simplex after ingestion of anchovies. Acta Derm Venereol 2002;82:121-123.
40. Ventura MT, Napolitano S, Menga R, Cecere R, Asero R. Anisakis simplex hypersensitivity is associated with chronic urticaria in endemic areas. Int Arch Allergy Immunol 2013;160:297-300.
41. Dionigi PC, Menezes MC, Forte WC. A prospective ten-year follow-up of patients with chronic urticaria. Allergol Immunopathol (Madr) 2016;44:286-291.
42. Shabrawy RM, Gharib K. Helicobacter pylori Infection as a risk factor in patients suffering from food allergy and urticaria. Egypt J Immunol 2016;23:67-75.
43. Curth HM, Dinter J, Nigemeier K, Kutting F, Hunzelmann N, Steffen HM. Effects of Helicobacter pylori eradication in chronic spontaneous urticaria: results from a retrospective cohort study. Am J Clin Dermatol 2015;16:553-558.
44. Rasooly MM, Moye NA, Kirshenbaum AS. Helicobacter pylori: a significant and treatable cause of chronic urticaria and angioedema. Nurse Pract 2015;40:1-6.
45. Chen YJ, Wu CY, Shen JL, Chen TT, Chang YT. Cancer risk in patients with chronic urticaria: a population-based cohort study. Arch Dermatol 2012;148:103-108.
46. Konstantinou GN, Asero R, Maurer M, Sabroe RA, Schmid-Grendelmeier P, Grattan CE. EAACI/GA(2)LEN task force consensus report: the autologous serum skin test in urticaria. Allergy 2009;64:1256-1268.
47. Konstantinou GN, Asero R, Ferrer M, et al. EAACI taskforce position paper: evidence for autoimmune urticaria and proposal for defining diagnostic criteria. Allergy 2013;68:27-36.
48. Curto-Barredo L, Yelamos J, Gimeno R, Mojal S, Pujol RM, Gimenez-Arnau A. Basophil Activation Test identifies the patients with Chronic Spontaneous Urticaria suffering the most active disease. Immun Inflamm Dis 2016;4:441-445.
49. Netchiporouk E, Moreau L, Rahme E, Maurer M, Lejtenyi D, Ben-Shoshan M. Positive CD63 basophil activation tests are common in children with chronic spontaneous urticaria and linked to high disease activity. Int Arch Allergy Immunol 2016;171:81-88.
50. Kim Z, Choi BS, Kim JK, Won DI. Basophil markers for identification and activation in the indirect basophil activation test by flow cytometry for diagnosis of autoimmune urticaria. Ann Lab Med 2016;36:28-35.
51. Iqbal K, Bhargava K, Skov PS, Falkencrone S, Grattan CE. A positive serum basophil histamine release assay is a marker for ciclosporin-responsiveness in patients with chronic spontaneous urticaria. Clin Transl Allergy 2012;2:19.
52. Gericke J, Metz M, Ohanyan T, et al. Serum autoreactivity predicts time to response to omalizumab therapy in chronic spontaneous urticaria. J Allergy Clin Immunol 2017;139:1059-1061.
53. Grattan CEH, Dawn G, Gibbs S, Francis DM. Blood basophil numbers in chronic ordinary urticaria and healthy controls: diurnal variation, influence of loratadine and prednisolone and relationship to disease activity. Clin Exp Allergy 2003;33:337-341.
54. Eckman JA, Hamilton RG, Gober LM, Sterba PM, Saini SS. Basophil phenotypes in chronic idiopathic urticaria in relation to disease activity and autoantibodies. J Invest Dermatol 2008;128:1956-1963.
55. Saini SS, Omachi TA, Trzaskoma B, et al. Effect of omalizumab on blood basophil counts in patients with chronic idiopathic/spontaneous urticaria. J Invest Dermatol 2017;137:958-961.
56. Kolkhir P, Andre F, Church MK, Maurer M, Metz M. Potential blood biomarkers in chronic spontaneous urticaria. Clin Exp Allergy 2017;47:19-36.
57. Asero R, Marzano AV, Ferrucci S, Cugno M. D-dimer plasma levels parallel the clinical response to omalizumab in patients with severe chronic spontaneous urticaria. Int Arch Allergy Immunol 2017;172:40-44.
58. Mlynek A, Zalewska-Janowska A, Martus P, Staubach P, Zuberbier T, Maurer M. How to assess disease activity in patients with chronic urticaria? Allergy 2008;63:777-780.
59. Hawro T, Ohanyan T, Schoepke N, et al. Comparison and interpretability of the available urticaria activity scores. Allergy 2017;73:251-255.
60. Weller KG, Magerl M, Tohme N, et al. Development, validation and initial results of the angioedema activity score. Allergy 2013;68:1185-1192.
61. Ohanyan T, Schoepke N, Bolukbasi B, et al. Responsiveness and minimal important difference of the urticaria control test. J Allergy Clin Immunol 2017;140:1710-1713.
62. Weller K, Groffik A, Church MK, et al. Development and validation of the Urticaria Control Test: a patient-reported outcome instrument for assessing urticaria control. J Allergy Clin Immunol 2014;133:1365-1372.
63. Martinez-Escala ME, Curto-Barredo L, Carnero L, Pujol RM, Gimenez-Arnau AM. Temperature thresholds in assessment of the clinical course of acquired cold contact urticaria: a prospective observational one-year study. Acta Derm Venereol 2015;95:278-282.
64. Abajian M, Curto-Barredo L, Krause K, et al. Rupatadine 20 mg and 40 mg are effective in reducing the symptoms of chronic cold urticaria. Acta Derm Venereol 2016;96:56-59.
65. Mlynek A, Magerl M, Siebenhaar F, et al. Results and relevance of critical temperature threshold testing in patients with acquired cold urticaria. Br J Dermatol 2010;162:198-200.
66. Koch K, Weller K, Werner A, Maurer M, Altrichter S. Antihistamine updosing reduces disease activity in patients with difficult-to-treat cholinergic urticaria. J Allergy Clin Immunol 2016;138:1483-1485.
67. Maurer M, Schutz A, Weller K, et al. Omalizumab is effective in symptomatic dermographism-results of a randomized placebo-controlled trial. J Allergy Clin Immunol 2017;140:870-873.
68. Metz M, Schutz A, Weller K, et al. Omalizumab is effective in cold urticaria-results of a randomized placebo-controlled trial. J Allergy Clin Immunol 2017;140:864-867.
69. Magerl M, Altrichter S, Borzova E, et al. The definition, diagnostic testing, and management of chronic inducible urticarias – the EAACI/GA(2) LEN/EDF/UNEV consensus recommendations 2016 update and revision. Allergy 2016;71:780-802.
70. Magerl M, Abajian M, Krause K, Altrichter S, Siebenhaar F, Church MK. An improved Peltier effect-based instrument for critical temperature threshold measurement in cold- and heat-induced urticaria. J Eur Acad Dermatol Venereol 2015;29:2043-2045.
71. Schoepke N, Abajian M, Church MK, Magerl M. Validation of a simplified provocation instrument for diagnosis and threshold testing of symptomatic dermographism. Clin Exp Dermatol 2015;40:399-403.
72. Mlynek A, Vieira dos Santos R, Ardelean E, et al. A novel, simple, validated and reproducible instrument for assessing provocation threshold levels in patients with symptomatic dermographism. Clin Exp Dermatol 2013;38:360-366.
73. Altrichter S, Salow J, Ardelean E, Church MK, Werner A, Maurer M. Development of a standardized pulse-controlled ergometry test for diagnosing and investigating cholinergic urticaria. J Dermatol Sci 2014;75:88-93.
74. Azkur D, Civelek E, Toyran M, et al. Clinical and etiologic evaluation of the children with chronic urticaria. Allergy Asthma Proc 2016;37:450-457.
75. Lee SJ, Ha EK, Jee HM, et al. Prevalence and risk factors of urticaria with a focus on chronic urticaria in children. Allergy Asthma Immunol Res 2017;9:212-219.
76. Church MK, Weller K, Stock P, Maurer M. Chronic spontaneous urticaria in children: itching for insight. Pediatr Allergy Immunol 2011;22:1-8.
77. Maurer M, Church MK, Weller K. Chronic urticaria in children – still itching for insight. JAMA Dermatol 2017;153:1221-1222.
78. Kuemmerle-Deschner JB, Ozen S, Tyrrell PN, et al. Diagnostic criteria for cryopyrin-associated periodic syndrome (CAPS). Ann Rheum Dis 2017;76:942-947.
79. Kowalski ML, Woessner K, Sanak M. Approaches to the diagnosis and management of patients with a history of nonsteroidal anti-inflammatory drug-related urticaria and angioedema. J Allergy Clin Immunol 2015;136:245-251.
80. Shakouri A, Compalati E, Lang DM, Khan DA. Effectiveness of Helicobacter pylori eradication in chronic urticaria: evidence-based analysis using the grading of recommendations assessment, development, and evaluation system. Curr Opin Allergy Clin Immunol 2010;10:362-369.
81. Ishaq S, Nunn L. Helicobacter pylori and gastric cancer: a state of the art review. Gastroenerol Hepatol Bed Bench 2015;8(Suppl1):6-14.
82. Henz BM, Zuberbier T. Causes of urticaria. In: Henz BM, Zuberbier T, Grabbe J, Monroe E, eds. Urticaria – clinical, diagnostic and therapeutic aspects. Berlin: Springer; 1998.
83. Ergon MC, ilknur T, Yucesoy M, Ozkan S. Candida spp. colonization and serum anticandidal antibody levels in patients with chronic urticaria. Clin Exp Dermatol 2007;32:740-743.
84. Zuberbier T, ChantraineKess S, Hartmann K, Czarnetzki BM. Pseudoallergen-free diet in the treatment of chronic urticaria – a prospective study. Acta Derm Venereol 1995;75:484-487.
85. Bruno G, Andreozzi P, Graf U. Exercise-induced urticaria-angioedema syndrome: a role in gastroesophageal reflux. In: Vena GA, Puddu P, eds. Proceedings of the international symposium on urticaria. Bari, Milan: Editrice CSH; 1998: 85-89.
86. Varghese R, Rajappa M, Chandrashekar L, et al. Association among stress, hypocortisolism, systemic inflammation, and disease severity in chronic urticaria. Ann Allergy Asthma Immunol 2016;116:344-348.
87. Kounis NG, Kounis GN, Soufras GD. Exercise-induced urticaria, cholinergic urticaria, and Kounis syndrome. J Pharmacol Pharmacother 2016;7:48-50.
88. Grattan CE, Francis DM, Slater NG, Barlow RJ, Greaves MW. Plasmapheresis for severe, unremitting, chronic urticaria. Lancet 1992;339:1078-1080.
89. Juhlin L. Recurrent urticaria: clinical investigation of 330 patients. Br J Dermatol 1981;104:369-381.
90. Pfrommer C, Bastl R, Vieths S, Ehlers I, Henz BM, Zuberbier T. Characterization of naturally occurring pseudoallergens causing chronic urticaria. J Allergy Clin Immunol 1996;97:367.
91. Pigatto PD, Valsecchi RH. Chronic urticaria: a mystery. Allergy 2000;55:306-308.
92. Bunselmeyer B, Laubach HJ, Schiller M, Stanke M, Luger TA, Brehler R. Incremental build-up food challenge–a new diagnostic approach to evaluate pseudoallergic reactions in chronic urticaria: a pilot study: stepwise food challenge in chronic urticaria. Clin Exp Allergy 2009;39:116-126.
93. Nettis E, Colanardi MC, Ferrannini A, Tursi A. Sodium benzoate-induced repeated episodes of acute urticaria/angio-oedema: randomized controlled trial. Br J Dermatol 2004;151:898-902.
94. Akoglu G, Atakan N, Cakir B, Kalayci O, Hayran M. Effects of low pseudoallergen diet on urticarial activity and leukotriene levels in chronic urticaria. Arch Dermatol Res 2012;304:257-262.
95. Wagner N, Dirk D, Peveling-Oberhag A, et al. A Popular myth – low-histamine diet improves chronic spontaneous urticaria – fact or fiction? J Eur Acad Dermatol Venereol 2016;31:650-655.
96. Beissert S, Stander H, Schwarz T. UVA rush hardening for the treatment of solar urticaria. J Am Acad Dermatol 2000;42:1030-1032.
97. Grob JJ, Auquier P, Dreyfus I, Ortonne JP. How to prescribe antihistamines for chronic idiopathic urticaria: desloratadine daily vs PRN and quality of life. Allergy 2009;64:605-612.
98. Weller K, Ardelean E, Scholz E, Martus P, Zuberbier T, Maurer M. Can on-demand non-sedating antihistamines improve urticaria symptoms? A double-blind, randomized, Single-dose study. Acta Derm Venereol 2013;93:168-174.
99. Vonakis BM, Saini SS. New concepts in chronic urticaria. Curr Opin Immunol 2008;20:709-716.
100. Church MK, Maurer M, Simons FE, et al. Risk of first-generation H(1)-antihistamines: a GA(2)LEN position paper. Allergy 2010;65:459-466.
101. Bousquet J, Khaltaev N, Cruz AA, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008;63(Suppl 86):8-160.
102. Kubo N, Senda M, Ohsumi Y, et al. Brain histamine H1 receptor occupancy of loratadine measured by positron emission topography: comparison of H1 receptor occupancy and proportional impairment ratio. Hum Psychopharmacol 2011;26:133-139.
103. Kontou-Fili K, Paleologos G, Herakleous M. Suppression of histamine-induced skin reactions by loratadine and cetirizine diHCl. Eur J Clin Pharmacol 1989;36:617-619.
104. Zuberbier T, Munzberger C, Haustein U, et al. Double-blind crossover study of high-dose cetirizine in cholinergic urticaria. Dermatology 1996;193:324-327.
105. Kontou-Fili KK, Maniakatou G, Demaka P. Therapeutic effect of cetirizine 2 HCl in delayed pressure urticaria. Health Sci Rev 1989;3:23-25.
106. Wanderer AA, Ellis EF. Treatment of cold urticaria with cyproheptadine. J Allergy Clin Immunol 1971;48:366-371.
107. Kaplan AP, Gray L, Shaff RE, Horakova Z, Beaven MA. In vivo studies of mediator release in cold urticaria and cholinergic urticaria. J Allergy Clin Immunol 1975;55:394-402.
108. Staevska M, Popov TA, Kralimarkova T, et al. The effectiveness of levocetirizine and desloratadine in up to 4 times conventional doses in difficult-to-treat urticaria. J Allergy Clin Immunol 2010;125:676-682.
109. Siebenhaar F, Degener F, Zuberbier T, Martus P, Maurer M. High-dose desloratadine decreases wheal volume and improves cold provocation thresholds compared with standard-dose treatment in patients with acquired cold urticaria: a randomized, placebo-controlled, crossover study. J Allergy Clin Immunol 2009;123:672-679.
110. Gimenez-Arnau A, Izquierdo I, Maurer M. The use of a responder analysis to identify clinically meaningful differences in chronic urticaria patients following placebo- controlled treatment with rupatadine 10 and 20 mg. J Eur Acad Dermatol Venereol 2009;23:1088-1091.
111. Guillen-Aguinaga S, Jauregui Presa I, Aguinaga-Ontoso E, Guillen-Grima F, Ferrer M. Updosing nonsedating antihistamines in patients with chronic spontaneous urticaria: a systematic review and meta-analysis. Br J Dermatol 2016;175:1153-1165.
112. Saini S, Rosen KE, Hsieh HJ, et al. A randomized, placebo-controlled, dose-ranging study of single-dose omalizumab in patients with H-1-antihistamine-refractory chronic idiopathic urticaria. J Allergy Clin Immunol 2011;128:567-U195.
113. Maurer M, Altrichter S, Bieber T, et al. Efficacy and safety of omalizumab in patients with chronic urticaria who exhibit IgE against thyroperoxidase. J Allergy Clin Immunol 2011;128:202-209.
114. Saini SS, Bindslev-Jensen C, Maurer M, et al. Efficacy and safety of omalizumab in patients with chronic idiopathic/spontaneous urticaria who remain symptomatic on H1 antihistamines: a randomized, placebo-controlled study. J Invest Dermatol 2015;135:67-75.
115. Maurer M, Rosen K, Hsieh HJ, et al. Omalizumab for the treatment of chronic idiopathic or spontaneous urticaria. N Engl J Med 2013;368:924-935.
116. Kaplan A, Ledford D, Ashby M, et al. Omalizumab in patients with symptomatic chronic idiopathic/spontaneous urticaria despite standard combination therapy. J Allergy Clin Immunol 2013;132:101-109.
117. Zhao ZT, Ji CM, Yu WJ, et al. Omalizumab for the treatment of chronic spontaneous urticaria: a meta-analysis of randomized clinical trials. J Allergy Clin Immunol 2016;137:1742-1750.
118. Maurer M, Metz M, Brehler R, et al. Omalizumab treatment in chronic inducible urticaria: a systematic review of published evidence. J Allergy Clin Immunol 2017; in press.
119. Metz M, Altrichter S, Ardelean E, et al. Anti-immunoglobulin E treatment of patients with recalcitrant physical urticaria. Int Arch Allergy Immunol 2011;154:177-180.
120. Metz M, Bergmann P, Zuberbier T, Maurer M. Successful treatment of cholinergic urticaria with anti-immunoglobulin E therapy. Allergy 2008;63:247-249.
121. Boyce JA. Successful treatment of cold-induced urticaria/anaphylaxis with anti-IgE. J Allergy Clin Immunol 2006;117:1415-1418.
122. Guzelbey O, Ardelean E, Magerl M, Zuberbier T, Maurer M, Metz M. Successful treatment of solar urticaria with anti-immunoglobulin E therapy. Allergy 2008;63:1563-1565.
123. Bullerkotte U, Wieczorek D, Kapp A, Wedi B. Effective treatment of refractory severe heat urticaria with omalizumab. Allergy 2010;65:931-932.
124. Krause K, Ardelean E, Kessler B, et al. Antihistamine-resistant urticaria factitia successfully treated with anti-immunoglobulin E therapy. Allergy 2010;65:1494-1495.
125. Bindslev-Jensen C, Skov PS. Efficacy of omalizumab in delayed pressure urticaria: a case report. Allergy 2010;65:138-139.
126. Staubach P, Metz M, Chapman-Rothe N, et al. Effect of omalizumab on angioedema in H1 -antihistamine-resistant chronic spontaneous urticaria patients: results from X-ACT, a randomized controlled trial. Allergy 2016;71:1135-1144.
127. Maurer M, Sofen H, Ortiz B, Kianifard F, Gabriel S, Bernstein JA. Positive impact of omalizumab on angioedema and quality of life in patients with refractory chronic idiopathic/spontaneous urticaria: analyses according to the presence or absence of angioedema. J Eur Acad Dermatol Venereol 2017;31:1056-1063.
128. Maurer M, Kaplan A, Rosén K, et al. The XTEND-CIU study: long term use of Omalizumab in Chronic Idiopathic Urticaria. J Allergy Clin Immunol 2017; in press.
129. Metz M, Ohanyan T, Church MK, Maurer M. Retreatment with omalizumab results in rapid remission in chronic spontaneous and inducible urticaria. JAMA Dermatol 2014;150:288-290.
130. Stellato C, de Paulis A, Ciccarelli A, et al. Anti-inflammatory effect of cyclosporin A on human skin mast cells. J Invest Dermatol 1992;98:800-804.
131. Harrison CA, Bastan R, Peirce MJ, Munday MR, Peachell PT. Role of calcineurin in the regulation of human lung mast cell and basophil function by cyclosporine and FK506. Br J Pharmacol 2007;150:509-518.
132. Grattan CE, O'Donnell BF, Francis DM, et al. Randomized double-blind study of cyclosporin in chronic ‘idiopathic’ urticaria. Br J Dermatol 2000;143:365-372.
133. Vena GA, Cassano N, Colombo D, Peruzzi E, Pigatto P. Cyclosporine in chronic idiopathic urticaria: a double-blind, randomized, placebo-controlled trial. J Am Acad Dermatol 2006;55:705-709.
134. Kulthanan K, Chaweekulrat P, Komoltri C, et al. Cyclosporine for chronic spontaneous urticaria: a meta-analysis and systematic review. J Allergy Clin Immunol Pract 2017; in press.
135. Doshi DR, Weinberger MM. Experience with cyclosporine in children with chronic idiopathic urticaria. Pediatr Dermatol 2009;26:409-413.
136. Zuberbier T, Ifflander J, Semmler C, Henz BM. Acute urticaria: clinical aspects and therapeutic responsiveness. Acta Derm Venereol 1996;76:295-297.
137. Asero R, Tedeschi A. Usefulness of a short course of oral prednisone in antihistamine-resistant chronic urticaria: a retrospective analysis. J Investig Allergol Clin Immunol 2010;20:386-390.
138. Rutkowski K, Grattan CEH. How to manage chronic urticaria ‘beyond’ guidelines: a practical algorithm. Clin Exp Allergy 2017;47:710-718.
139. Magerl M, Philipp S, Manasterski M, Friedrich M, Maurer M. Successful treatment of delayed pressure urticaria with anti-TNF-alpha. J Allergy Clin Immunol 2007;119:752-754.
140. O'Donnell BF, Barr RM, Black AK, et al. Intravenous immunoglobulin in autoimmune chronic urticaria. Br J Dermatol 1998;138:101-106.
141. Dawn G, Urcelay M, Ah-Weng A, O'Neill SM, Douglas WS. Effect of high-dose intravenous immunoglobulin in delayed pressure urticaria. Br J Dermatol 2003;149:836-840.
142. Pereira C, Tavares B, Carrapatoso I, et al. Low-dose intravenous gammaglobulin in the treatment of severe autoimmune urticaria. Eur Ann Allergy Clin Immunol 2007;39:237-242.
143. Mitzel-Kaoukhov H, Staubach P, Muller-Brenne T. Effect of high-dose intravenous immunoglobulin treatment in therapy-resistant chronic spontaneous urticaria. Ann Allergy Asthma Immunol 2010;104:253-258.
144. Bangsgaard N, Skov L, Zachariae C. Treatment of refractory chronic spontaneous urticaria with adalimumab. Acta Derm Venereol 2017;97:524-525.
145. Sand FL, Thomsen SF. TNF-alpha inhibitors for chronic urticaria: experience in 20 patients. J Allergy (Cairo) 2013;2013:130905.
146. Hannuksela M, Kokkonen EL. Ultraviolet light therapy in chronic urticaria. Acta Derm Venereol 1985;65:449-450.
147. Borzova E, Rutherford A, Konstantinou GN, Leslie KS, Grattan CEH. Narrowband ultraviolet B phototherapy is beneficial in antihistamine-resistant symptomatic dermographism: a pilot study. J Am Acad Dermatol 2008;59:752-757.
148. Engin B, Ozdemir M, Balevi A, Mevlitoglu I. Treatment of chronic urticaria with narrowband ultraviolet B phototherapy: a randomized controlled trial. Acta Derm Venereol 2008;88:247-251.
149. Thormann J, Laurberg G, Zachariae H. Oral sodium cromoglycate in chronic urticaria. Allergy 1980;35:139-141.
150. Laurberg G. Tranexamic acid (Cyklokapron) in chronic urticaria: a double-blind study. Acta Derm Venereol 1977;57:369-370.
151. Lawlor F, Ormerod AD, Greaves MW. Calcium antagonist in the treatment of symptomatic dermographism. Low-dose and high-dose studies with nifedipine. Dermatologica 1988;177:287-291.
152. Lawlor F, Black AK, Ward AM, Morris R, Greaves MW. Delayed pressure urticaria, objective evaluation of a variable disease using a dermographometer and assessment of treatment using colchicine. Br J Dermatol 1989;120:403-408.
153. Dover JS, Black AK, Ward AM, Greaves MW. Delayed pressure urticaria. Clinical features, laboratory investigations, and response to therapy of 44 patients. J Am Acad Dermatol 1988;18:1289-1298.
154. Asero R, Tedeschi A, Cugno M. Heparin and tranexamic Acid therapy may be effective in treatment-resistant chronic urticaria with elevated d-dimer: a pilot study. Int Arch Allergy Immunol 2010;152:384-389.
155. Nayak AS, Berger WE, LaForce CF, et al. Randomized, placebo-controlled study of cetirizine and loratadine in children with seasonal allergic rhinitis. Allergy Asthma Proc 2017;38:222-230.
156. Gupta S, Khalilieh S, Kantesaria B, Banfield C. Pharmacokinetics of desloratadine in children between 2 and 11 years of age. Br J Clin Pharmacol 2007;63:534-540.
157. Gupta SK, Kantesaria B, Banfield C, Wang Z. Desloratadine dose selection in children aged 6 months to 2 years: comparison of population pharmacokinetics between children and adults. Br J Clin Pharmacol 2007;64:174-184.
158. Meltzer EO, Scheinmann P, Rosado Pinto JE, et al. Safety and efficacy of oral fexofenadine in children with seasonal allergic rhinitis–a pooled analysis of three studies. Pediatr Allergy Immunol 2004;15:253-260.
159. Pampura AN, Papadopoulos NG, Spicak V, Kurzawa R. Evidence for clinical safety, efficacy, and parent and physician perceptions of levocetirizine for the treatment of children with allergic disease. Int Arch Allergy Immunol 2011;155:367-378.
160. Potter P, Mitha E, Barkai L, et al. Rupatadine is effective in the treatment of chronic spontaneous urticaria in children aged 2-11 years. Pediatr Allergy Immunol 2016;27:55-61.
161. Novak Z, Yanez A, Kiss I, et al. Safety and tolerability of bilastine 10 mg administered for 12 weeks in children with allergic diseases. Pediatr Allergy Immunol 2016;27:493-498.
162. Weber-Schoendorfer C, Schaefer C. The safety of cetirizine during pregnancy. A prospective observational cohort study. Reprod Toxicol 2008;26:19-23.
163. Schwarz EBMM, Nayak S, Koren G. Risk of hypospadias in offspring of women using loratadine during pregnancy: a systematic review and meta-analysis. Drug Saf 2008;31:775-788.
164. Namazy J, Cabana MD, Scheuerle AE, et al. The Xolair Pregnancy Registry (EXPECT): the safety of omalizumab use during pregnancy. J Allergy Clin Immunol 2015;135:407-412.
165. González-Medina M, Curto-Barredo L, Labrador-Horrillo M, Giménez-Arnau A. Omalizumab use during pregnancy for chronic spontaneous urticaria (CSU): report of two cases. J Eur Acad Dermatol Venereol 2017;31:e245-e246.
166. Ghazanfar MN, Thomsen SF. Successful and safe treatment of chronic spontaneous urticaria with omalizumab in a woman during two consecutive pregnancies. Case Rep Med 2015;2015:368053.
167. Balshem H, Helfand M, Schunemann HJ, et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol 2011;64:401-406.
168. Maurer M. Cold urticaria. In: Saini SS, Callen J, editors. UpToDate. Boston, MA: Wolters Kluwer Health; 2014.