Publication: Treatments of cold urticaria: A systematic review
Issued Date
2019-04-01
Resource Type
ISSN
10976825
00916749
00916749
Other identifier(s)
2-s2.0-85063373443
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of Allergy and Clinical Immunology. Vol.143, No.4 (2019), 1311-1331
Suggested Citation
Kanokvalai Kulthanan, Saowalak Hunnangkul, Papapit Tuchinda, Leena Chularojanamontri, Puncharas Weerasubpong, Chanika Subchookul, Marcus Maurer Treatments of cold urticaria: A systematic review. Journal of Allergy and Clinical Immunology. Vol.143, No.4 (2019), 1311-1331. doi:10.1016/j.jaci.2019.02.005 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/51082
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Title
Treatments of cold urticaria: A systematic review
Abstract
© 2019 American Academy of Allergy, Asthma & Immunology Background: Several treatment options for cold urticaria (ColdU) have been studied and reported, but systematic reviews and meta-analyses are limited. Objectives: We sought to meta-analyze and review the efficacy and safety of ColdU treatments. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Suitable reports were identified by searching PubMed, Scopus, and Web of Science. Our systematic review included 16 studies, 9 of which met the eligibility criteria for the meta-analysis. We analyzed the effects of treatments on critical temperature thresholds (CTTs) and critical stimulation time thresholds (CSTTs), as well as on rates of complete response and adverse events. Results: Our pooled meta-analyses showed that nonsedating second-generation H 1 -antihistamines (nsAHs) are effective in the treatment of ColdU and that updosing of nsAHs significantly reduced CTTs relative to their own standard doses and placebos. In 4 studies involving CSTTs, updosing of nsAHs also resulted in significantly better CSTTs than their own standard doses or placebos. Omalizumab resulted in a marked reduction of CTTs in H 1 -antihistamine–resistant patients. Of 118 adverse events in 8 studies, standard-dose nsAHs, updosed nsAHs, and omalizumab produced lower numbers of adverse events than first-generation antihistamines. Conclusions: Our study showed that greater dosages of nsAHs were more effective than standard dosages in controlling ColdU symptoms. Increasing the dosages was not significantly associated with higher adverse event rates. Omalizumab at 150 and 300 mg every 4 weeks was shown to be effective for patients with ColdU refractory to antihistamines.