Calculator Predicts Antihistamine Response in Urticaria
Researchers validated a prognostic calculator that uses six readily available variables to predict which patients with chronic spontaneous urticaria (CSU) are likely to respond to antihistamine therapy.
METHODOLOGY:
The tool considers age, angioedema, anxiety/depression, disease duration, hypersensitivity to nonsteroidal anti-inflammatory drugs, and the Urticaria Activity Score (UAS) to predict response to treatment.
To assess its accuracy, the researchers conducted a prospective cohort study involving 542 patients with CSU from Colombia, Ecuador, Peru, and Argentina.
The calculator stratified patients as having a high or low probability of responding to antihistamines.
The researchers used the 7-day UAS to determine clinical response, with a score of 6 or less indicating control of the disease.
TAKEAWAY:
The prognostic model had 78.6% accuracy, the researchers reported.
It correctly predicted 82.9% of the nonresponders and 72.7% of the responders.
The type of antihistamine used did not affect the performance of the model, the researchers found. Medications used in the study included loratadine, cetirizine, levocetirizine, desloratadine, fexofenadine, and bilastine.
IN PRACTICE:
'Predicting the clinical response can help to promptly identify patients who could benefit from the use of alternative therapies and avoid prolonged times when evaluating anti-H1 [antihistamine] therapeutic response (eg, start immediately with the highest dose and prioritize clinical appointment in a few weeks),' the study authors wrote.
SOURCE:
Jorge Sánchez, MD, PhD, with the University of Antioquia, Medellín, Colombia, was the corresponding author of the study, which was published online on June 4 in The Journal of Allergy and Clinical Immunology: In Practice.
LIMITATIONS:
The study did not include children. The calculator needs to be validated on other continents, the authors said.
DISCLOSURES:
This study was supported by the University of Antioquia and Alma Mater de Antioquia Hospital. The authors reported having no conflicts of interest.
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