Medication used to control symptoms of chronic urticaria in children

Abstract

BACKGROUND: A number of guidelines for management of CU were established based on evidences in adults. In children, the response to CU treatment was not widely studied. OBJECTIVE: To investigate the medications used to control symptoms of CU in children and to identify factors associated with time to control CU. METHODS: Medical records of children with controlled CU visiting Allergy clinic, Siriraj hospital were examined. Controlled CU was defined as no urticarial lesion while the patients used the same daily medications over 8-12 weeks. Demographic data, clinical progression of CU and medications used in each visit were recorded. The steps of CU management were categorized into groups according to the Joint Task Force Practice Parameter (JTFPP) in CU 2014 guideline. RESULTS: One hundred children (48 males) with 'controlled CU' were recruited. The median age at first visit was 8 (5.4010.60) years. Thirty-two percent of the patients had associated angioedema. The median time to control CU was 9 (6.9011.10) months. Forty-four percent of the patients control CU with standard dose of second generation antihistamine (step 1) and the rest of the patients used the medications in step 2 to control CU. None of the patients needed systemic corticosteroid or immunomodulatory agent. The steps of treatment, angioedema and associated conditions related to CU did not affect time to control. CONCLUSIONS: Only up to a half of pediatric patients with CU had a favorable response to standard dose of second generation antihistamine. The rest required step 2 treatment of JTFPP to control their symptoms.