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

Werner Aberer,Torsten Zuberbier ,Martin Metz ,Roberta Buense Bedrikow ,Elias Toubi ,Alexander Nast ,Margarida Gonçalo ,Zenon Brzoza ,Hanneke Oude-Elberink ,Gordon Sussman ,И В Данилычева ,Barbara Ballmer‐Weber ,Eustachio Nettis ,Clive Grattan ,Désirée Larenas‐Linnemann ,Gino Antonio Veña ,P Mathelier‐Fusade ,Tabi A Leslie ,Ricardo Niklas Werner ,Jacques Hébert ,Corinna Dressler ,Markus Magerl ,Riccardo Asero ,Raisa Meshkova ,Timothy J Craig ,Michihiro Hide ,Ana Giménez‐Arnau ,Alexander Kapp ,Kiran Godse ,Christian Vestergaard ,Luis Felipe Ensina ,Constance H Katelaris ,Stefanie Rosumeck ,Zuotao Zhao ,Peter Schmid‐Grendelmeier ,Sarbjit S Saini ,Carsten Bindslev‐Jensen ,Giorgio Walter Canonica ,Kanokvalai Kulthanan ,Jonathan A Bernstein ,Mario Sánchez‐Borges ,Petra Staubach ,Emek Kocatürk ,Bettina Wedi ,Martin K Church ,Diane R Baker ,Allen P Kaplan ,Amir Hamzah Abdul Latiff ,Marcus Maurer

doi:10.26416/aler.6.4.2021.5815

Abstract

This evidence- and consensus-based guideline was developed following the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. The conference was held on 1 December 2016. It is a joint initiative of the Dermatology Section of the European Academy of Allergology and Clinical Immunology (EAACI), the EU-founded network of excellence, the Global Allergy and Asthma European Network (GA²LEN), the European Dermatology Forum (EDF) and the World Allergy Organization (WAO) with the participation of 48 delegates of 42 national and international societies. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS). Urticaria is a frequent, mast cell-driven disease, presenting with wheals, angioedema, or both. The lifetime prevalence for acute urticaria is approximately 20%. Chronic spontaneous urticaria and other chronic forms of urticaria are disabling, impair quality of life and affect performance at work and school. This guideline covers the definition and classification of urticaria, taking into account the recent progress in identifying its causes, eliciting factors and pathomechanisms. In addition, it outlines evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria.

Highlights

This evidence and consensus-based guideline was developed following the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group
The detailed methods used to develop this revision and update of the European Academy of Allergology and Clinical Immunology (EAACI)/GA2LEN/European Dermatology Forum (EDF)/World Allergy Organization (WAO) guideline on urticaria are published as separate methods report, including all GRADE tables (Insert REF to methods report including DOI)
This updated and revised guideline takes into account the Appraisal of Guidelines Research and Evaluation (AGREE II) Instrument [5] and the methods suggested by the GRADE working group

Summary

Introduction

This evidence and consensus-based guideline was developed following the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. In patients with a history suggestive of inducible urticaria standardized provocation testing according to international consensus recommendations [36] should be performed. We recommend that differential diagnoses be considered in all patients with signs or symptoms suggestive of chronic urticaria based on the

Results

Conclusion