Abstract
BackgroundChronic urticaria (CU) is a common disease which represents a considerable burden for many patients. The current urticaria guideline describes the evidence-based diagnosis and treatment of CU. In addition, however, questions often arise in everyday practice that are not addressed by the guideline.MethodsIn May 2020, a digital meeting with German urticaria experts was held, in which practical aspects of CU treatment were discussed and supporting aids for everyday clinical treatment formulated. The resulting advice in this document focus on practical questions and the available literature and experiences of the participants.ResultsThe diagnosis of CU can be made in a short time by means of a thorough anamnesis, a physical examination, and a basic laboratory chemical diagnosis. For this purpose, practical recommendations for everyday practice are given in this paper. An extended diagnosis is only indicated in a few cases and should always be carried out in parallel with an effective therapy. In general, CU should always be treated in the same way, regardless of whether wheals, angioedema or both occur. Symptomatic therapy should be carried out according to the treatment steps recommended by the guidelines. This publication provides practical advice on issues in everyday practice, such as the procedure in the current coronavirus disease 2019 (COVID-19) pandemic, the cardiac risk under higher dosed H1 antihistamines, the self-administration of omalizumab as well as vaccination under omalizumab therapy. In addition to treatment recommendations, topics such as documentation in the practice and family planning with urticaria will be discussed.DiscussionThese supporting treatment recommendations serve as an addendum to the current CU guideline and provide support in dealing with CU patients in everyday practice. The aim is to ensure that patients suffering from CU achieve complete freedom of symptoms with the help of an optimal therapy.Supplementary InformationThe online version of this article (10.1007/s40629-021-00162-w) contains supplementary material, which is available to authorized users.
Highlights
Chronic urticaria (CU; duration of symptoms longer than 6 weeks) is a common disease associated with a considerable burden for many patients, as itching, wheals and angioedema are often not sufficiently controlled
For patients who suffer from both CIndU and csU, therapy with omalizumab is within the label
With the aid of thorough anamnesis, physical examination, and basic laboratory diagnostics, a diagnosis can be made in a short time
Summary
Chronic urticaria (CU; duration of symptoms longer than 6 weeks) is a common disease associated with a considerable burden for many patients, as itching, wheals and angioedema are often not sufficiently controlled. This goal can be achieved with the currently available treatment options These are frequently not optimally implemented in clinical practices. The current urticaria guideline discusses in detail the evidence-based diagnosis and treatment of CU. Questions often arise in clinical everyday life For this reason, a meeting of German urticaria experts was held in May 2020 with the aim of discussing practice-relevant aspects of CU treatment and formulating supporting aids for everyday clinical treatment. A meeting of German urticaria experts was held in May 2020 with the aim of discussing practice-relevant aspects of CU treatment and formulating supporting aids for everyday clinical treatment These resulting pieces of advice serve as a supplement to the current CU guidelines. Questions often arise in everyday practice that are not addressed by the guideline
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