1
|
Rossi O, Piccirillo A, Iemoli E, Patrizi A, Stingeni L, Calvieri S, Gola M, Dapavo P, Cristaudo A, Zichichi L, Losappio L, Saccheri F, Pastorello EA. Socio-economic burden and resource utilisation in Italian patients with chronic urticaria: 2-year data from the AWARE study. World Allergy Organ J 2020; 13:100470. [PMID: 33343800 PMCID: PMC7726718 DOI: 10.1016/j.waojou.2020.100470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 09/04/2020] [Accepted: 09/10/2020] [Indexed: 11/10/2022] Open
Abstract
Introduction In Italy, the real-world evidence on the extent of adherence to guidelines and the benefits of recommended therapeutic medications and their impact on the quality of life (QoL) of H1-antihistamines (H1-AH) refractory chronic urticaria (CU) patients is limited. Methods AWARE (A World-wide Antihistamine-Refractory chronic urticaria patient Evaluation) was a global prospective, non-interventional study of CU in real-world setting which included patients aged ≥18 years with a medically confirmed diagnosed of CU present for more than 2 months. In this study, the disease characteristics, pharmacological treatments and patient-reported outcomes (PROs) are reported. Results In total, 159 patients from 24 study centres in Italy completed the study. At baseline, 221 (89.5%) and 8 (3.2%) patients had chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU), respectively, while 18 (7.3%) patients had concomitant CSU and CIndU. For CSU patients, mean dermatology life quality index and CU quality of life questionnaire scores reduced to 3.0 ± 4.9 and 14.6 ± 18.6 at Month 24 from baseline scores of 7.5 ± 6.6 and 33.2 ± 19.5, respectively, indicating an improvement in QoL. This was reflected in their work-life as work productivity impairment reduced considerably after 2 years. Only 71.9% CSU patients had a prior treatment, while during the study, 96.8% of the patients were treated with a medication. At baseline, only 52.9% CSU patients reported nonsedating H1-antihistamines as first-line of treatment in prior medication, this increased to 89.6% during current medication. Conclusion This study shows that CSU has a considerable socio-economic burden and an improvement in QoL can be achieved in CSU patients if an appropriate therapeutic path is followed.
Collapse
Key Words
- AWARE study
- CIndU, chronic inducible urticaria
- CSU, chronic spontaneous urticaria
- CU, chronic urticaria
- CU-Q2oL, CU quality of life questionnaire
- Chronic spontaneous urticaria
- DLQI, dermatology life quality index
- GCP, good clinical practices
- H1-AH, H1-antihistamines
- Italy
- PRO, patient-reported outcomes
- QoL, quality of life
- Resource utilisation
- SD, standard deviation
- Socio-economic burden
- UAS7, weekly urticaria activity score
- WPAI-CU, work productivity and activity impairment questionnaire
- nsAH, non-sedating H1-AH
- sAH, sedating H1-AH
Collapse
Affiliation(s)
- Oliviero Rossi
- Azienda Ospedaliera Universitaria Careggi, SOD Immunoallergologia, Florence, Italy
| | | | | | - Annalisa Patrizi
- UOC Dermatologia Metropolitana, DIMES, University Bologna, Italy
| | - Luca Stingeni
- Section of Dermatology, Department of Medicine, University of Perugia, Italy
| | | | - Massimo Gola
- AOU Ospedale Piero Palagi/IOT UOC Dermatologia, SAS Dermatologia Allergologica, Florence, Italy
| | - Paolo Dapavo
- A.O.U. Citta della Salute e della Scienza di Torino, Turin, Italy
| | | | | | | | | | | |
Collapse
|
2
|
Maurer M, Weller K, Magerl M, Maurer RR, Vanegas E, Felix M, Cherrez A, Mata VL, Kasperska-Zajac A, Sikora A, Fomina D, Kovalkova E, Godse K, Rao ND, Khoshkhui M, Rastgoo S, Criado RFJ, Abuzakouk M, Grandon D, van Doorn M, Valle SOR, de Souza Lima EM, Thomsen SF, Ramón GD, Matos Benavides EE, Bauer A, Giménez-Arnau AM, Kocatürk E, Guillet C, Ignacio Larco J, Zhao ZT, Makris M, Ritchie C, Xepapadaki P, Ensina LF, Cherrez S, Cherrez-Ojeda I. The usage, quality and relevance of information and communications technologies in patients with chronic urticaria: A UCARE study. World Allergy Organ J 2020; 13:100475. [PMID: 33204387 PMCID: PMC7606865 DOI: 10.1016/j.waojou.2020.100475] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/10/2020] [Accepted: 09/24/2020] [Indexed: 11/04/2022] Open
Abstract
Background Chronic urticaria (CU) is characterized by itchy recurrent wheals, angioedema, or both for 6 weeks or longer. CU can greatly impact patients' physical and emotional quality of life. Patients with chronic conditions are increasingly seeking information from information and communications technologies (ICTs) to manage their health. The objective of this study was to assess the frequency of usage and preference of ICTs from the perspective of patients with CU. Methods In this cross-sectional study, 1800 patients were recruited from primary healthcare centers, university hospitals or specialized clinics that form part of the UCARE (Urticaria Centers of Reference and Excellence) network throughout 16 countries. Patients were >12 years old and had physician-diagnosed chronic spontaneous urticaria (CSU) or chronic inducible urticaria (CIndU). Patients completed a 23-item questionnaire containing questions about ICT usage, including the type, frequency, preference, and quality, answers to which were recorded in a standardized database at each center. For analysis, ICTs were categorized into 3 groups as follows: one-to-one: SMS, WhatsApp, Skype, and email; one-to-many: YouTube, web browsers, and blogs or forums; many-to-many: Instagram, Twitter, Facebook, and LinkedIn. Results Overall, 99.6% of CU patients had access to ICT platforms and 96.7% had internet access. Daily, 85.4% patients used one-to-one ICT platforms most often, followed by one-to-many ICTs (75.5%) and many-to-many ICTs (59.2%). The daily ICT usage was highest for web browsers (72.7%) and WhatsApp (70.0%). The general usage of ICT platforms increased in patients with higher levels of education. One-to-many was the preferred ICT category for obtaining general health information (78.3%) and for CU-related information (75.4%). A web browser (77.6%) was by far the most commonly used ICT to obtain general health information, followed by YouTube (25.8%) and Facebook (16.3%). Similarly, for CU-specific information, 3 out of 4 patients (74.6%) used a web browser, 20.9% used YouTube, and 13.6% used Facebook. One in 5 (21.6%) patients did not use any form of ICT for obtaining information on CU. The quality of the information obtained from one-to-many ICTs was rated much more often as very interesting and of good quality for general health information (53.5%) and CU-related information (51.5%) as compared to the other categories. Conclusions Usage of ICTs for health and CU-specific information is extremely high in all countries analyzed, with web browsers being the preferred ICT platform.
Collapse
Key Words
- (3–5) ICT
- Apps, applications
- CIndU, chronic inducible urticaria
- CSU, chronic spontaneous urticaria
- CU, chronic urticaria
- HCP, healthcare provider
- ICT, information and communications technologies
- Information and communications technology
- SEM, self-management education
- SMS, short messaging service
- Self-management
- UAE, United Arab Emirates
- UCARE, Urticaria Centers of Reference and Excellence
- Urticaria
Collapse
Affiliation(s)
- Marcus Maurer
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany
| | - Karsten Weller
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany
| | - Markus Magerl
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany
| | - Rasmus Robin Maurer
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany
| | - Emanuel Vanegas
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respiralab, Respiralab Research Group, Guayaquil, Ecuador
| | - Miguel Felix
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respiralab, Respiralab Research Group, Guayaquil, Ecuador
| | - Annia Cherrez
- Respiralab, Respiralab Research Group, Guayaquil, Ecuador.,Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Valeria L Mata
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respiralab, Respiralab Research Group, Guayaquil, Ecuador
| | - Alicja Kasperska-Zajac
- European Center for Diagnosis and Treatment of Urticaria, Medical University of Silesia, Katowice, Poland
| | - Agnieszka Sikora
- European Center for Diagnosis and Treatment of Urticaria, Medical University of Silesia, Katowice, Poland
| | - Daria Fomina
- City Center of Allergy and Immunology, Clinical City Hospital #52, Moscow, Russia.,Department of Allergology and Clinical Immunology, I.M. Sechenov First Moscow State Medical University, Trubetskaya St., 8/2, Moscow, 119991, Russian Federation
| | - Elena Kovalkova
- City Center of Allergy and Immunology, Clinical City Hospital #52, Moscow, Russia
| | - Kiran Godse
- Department of Dermatology, D Y, Patil University School of Medicine and Hospital, Mumbai, India
| | - Nimmagadda Dheeraj Rao
- Department of Dermatology, D Y, Patil University School of Medicine and Hospital, Mumbai, India
| | - Maryam Khoshkhui
- Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Allergy and Immunology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sahar Rastgoo
- Department of Allergy and Immunology, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mohamed Abuzakouk
- Allergy and Immunology Department, Cleveland Clinic Abu Dhabi, The Uae
| | - Deepa Grandon
- Allergy and Immunology Department, Cleveland Clinic Abu Dhabi, The Uae
| | | | | | | | - Simon Francis Thomsen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Biomedical Sciences, Copenhagen, Denmark
| | - German D Ramón
- Instituto de Alergia e Inmunología del Sur, Bahía Blanca, De Buenos Aires, Argentina
| | - Edgar E Matos Benavides
- Centro de Referencia de Alergia, Asma e Inmunología - Instituto Nacional del Niño, Lima-Perú
| | - Andrea Bauer
- Department of Dermatology, University Allergy Center, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | | | - Emek Kocatürk
- Department of Dermatology, Koç University School of Medicine, Istanbul, Turkey
| | - Carole Guillet
- Department of Dermatology, University Hospital Zurich, Switzerland
| | | | - Zuo-Tao Zhao
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China
| | - Michael Makris
- Allergy Unit, 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, "Attikon" University Hospital, Greece
| | - Carla Ritchie
- Allergy Division, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Paraskevi Xepapadaki
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Greece
| | | | - Sofia Cherrez
- Department of Dermatology, SRH Zentralklinikum Suhl, Germany.,Respiralab, Respiralab Research Group, Guayaquil, Ecuador
| | - Ivan Cherrez-Ojeda
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respiralab, Respiralab Research Group, Guayaquil, Ecuador
| |
Collapse
|
3
|
Maurer M, Giménez-Arnau A, Ensina LF, Chu CY, Jaumont X, Tassinari P. Chronic urticaria treatment patterns and changes in quality of life: AWARE study 2-year results. World Allergy Organ J 2020; 13:100460. [PMID: 32983330 PMCID: PMC7493083 DOI: 10.1016/j.waojou.2020.100460] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/13/2020] [Accepted: 08/20/2020] [Indexed: 12/18/2022] Open
Abstract
Background A Worldwide Antihistamine-Refractory Chronic Urticaria (CU) patient Evaluation (AWARE) is a non-interventional, multicenter study including patients from Europe, Central and Latin America, Asia-Pacific, and the Middle East. AWARE describes real-world evidence for CU, including clinical characteristics, treatment patterns and the impact on quality of life. Methods Over the 2-year study, therapy changes, angioedema occurrence, and patient-reported outcomes (PROs) were recorded over 9 visits, including dermatology life quality index (DLQI) and 7-day urticaria activity score (UAS7). Data were stratified into subgroups: chronic spontaneous urticaria (CSU), chronic inducible urticaria (CIndU), or CSU + CIndU. Results Out of 4838 patients analyzed, 9.9% were receiving no treatment for their CU symptoms at baseline, and 20.4% were receiving first-line non-sedating H1-antihistamine at approved doses. The predominant baseline therapy was up-dosed non-sedating H1-antihistamines (25.5%). By Visit 2, omalizumab was the overall most commonly used therapy (29.6%), increasing to 30.1% by the end of the study. Baseline DLQI scores for patients with CSU, CIndU and CSU + CIndU were 8.3, 7.6 and 9.1, respectively; scores decreased over the study for CSU and CSU + CIndU patients, but fluctuated for CIndU patients. Baseline angioedema occurrence was higher in CSU and CSU + CIndU patients, reported in 45.4% and 45.5% of patients, respectively, compared to 17.0% in CIndU patients. By the final visit, angioedema had decreased to 11.9% and 11.2% for CSU and CSU + CIndU, respectively, and 9.6% for CIndU. Conclusion CU patients are undertreated at baseline; after entering the AWARE study, more patients received appropriate treatment. However, over two thirds are not escalated to third-line treatments.
Collapse
Key Words
- AMAC, Asia-Pacific and the Middle East
- AWARE, A Worldwide Antihistamine-Refractory Chronic Urticaria patient Evaluation
- Angioedema
- CIndU, chronic inducible urticaria
- CSU, chronic spontaneous urticaria
- CU, chronic urticaria
- DLQI, dermatology life quality index
- Dermatology
- LaCAN, Central and Latin America
- PRO, patient-reported outcome
- QoL, quality of life
- Quality-of-life
- SD, standard deviation
- UAS7, 7-day urticaria activity score
- Urticaria
Collapse
Affiliation(s)
- Marcus Maurer
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité -Universitätsmedizin Berlin, Germany
| | - Ana Giménez-Arnau
- Dermatology Department, Hospital del Mar. IMIM, Universitat Autònoma, Barcelona, Spain
| | - Luis Felipe Ensina
- CPAlpha Clinical Research Center, São Paulo, Brazil.,Hospital Sírio-Libanês, São Paulo, Brazil
| | - Chia-Yu Chu
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | | | | |
Collapse
|
4
|
Gonzalez-Diaz SN, Sanchez-Borges M, Rangel-Gonzalez DM, Guzman-Avilan RI, Canseco-Villarreal JI, Arias-Cruz A. Chronic urticaria and thyroid pathology. World Allergy Organ J 2020; 13:100101. [PMID: 32180891 PMCID: PMC7063156 DOI: 10.1016/j.waojou.2020.100101] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 11/27/2019] [Accepted: 12/31/2019] [Indexed: 12/11/2022] Open
Abstract
Urticaria is defined as the sudden appearance of erythematous, itchy wheals of variable size, with or without angioedema (AE) (swelling of the deeper layers of the skin). Its classification depends on time course of symptoms and the presence of eliciting factors. When it lasts less than 6 weeks it is classified as acute urticaria (AU), and if the symptoms persist for more than 6 weeks, it is classified as chronic urticaria (CU). Current International Guidelines also classify CU as chronic spontaneous urticaria (CSU) and inducible urticarial, according to the absence or presence of environmental triggering factors. CSU is defined as urticaria and/or angioedema in which there is no evidence of a specific eliciting factor. CSU is associated with autoimmunity in 30-45% of the cases, sharing some immunological mechanisms with other autoimmune diseases, and is associated with autoimmune thyroid disease (ATD) in about 4.3%-57.4% patients. Several studies suggest that adequate therapy with anti-thyroid drugs or levothyroxine in early stages of ATD and CSU, may help to remit the latter; but there is still a lack of double-blind, placebo-controlled studies that support this hypothesis in patients without abnormal thyroid hormone levels. The objective of this review is to describe the pathophysiology of chronic spontaneous urticaria and its association with autoimmune thyroid disease.
Collapse
Key Words
- AAbs, autoantibodies
- AD, autoimmune diseases
- AE, angioedema
- AMA, antithyroid microsomal antibody
- ASST, autologous serum skin test
- ATAbs, anti-thyroid autoantibodies
- ATD, autoimmune thyroid disease
- Autoimmunity
- BAT, basophil activation test
- CAU, chronic autoimmune urticaria
- CSU, chronic spontaneous urticaria
- CU, chronic urticaria
- Chronic urticaria
- DAMPs, damage-associated molecular patterns
- FcεRIa, high affinity IgE receptor
- GD, Graves' disease
- HT, Hashimoto's thyroiditis/autoimmune thyroiditis
- Histamine
- ICU, inducible chronic urticaria
- IFN-γ, gamma interferon
- IL, Interleukin
- IgE, Immunoglobulin E
- IgG, Immunoglobulin G
- Levothyroxine
- NSAH, non-sedating antihistamines
- PAF, platelet activating factor
- PAMPs, pathogen-associated molecular patterns
- T4L, free thyroxine
- TG, thyroglobulin
- TGAbs, anti-thyroglobulin antibodies
- TLR, Toll-like receptors
- TNF-α, tumor necrosis factor alpha
- TPOAbs, anti-thyroid peroxidase antibodies
- TSH, thyroid stimulating hormone
- TSHR, thyroid stimulating hormone receptor
- Thyroid disease
- Treg, regulatory T cells
- UAS, urticaria activity score
- Urticaria
- VEGF, vascular endothelial growth factor
Collapse
Affiliation(s)
- Sandra Nora Gonzalez-Diaz
- Centro Regional de Alergia e Inmunología Clinica, Hospital Universitario “Dr. José Eleuterio González”, Ave. Gonzalitos y Madero, s/n, Colonia Mitras Centro, CP. 64460, Monterrey, Nuevo Leon, Mexico
| | - Mario Sanchez-Borges
- Allergy and Clinical Immunology Department, Centro Medico Docente La Trinidad, Allergy Service, Clinica El Avila, 6a. Transversal Urb. Altamira, Piso 8, Consultorio 803, Caracas, 1060, Venezuela
| | - Diana Maria Rangel-Gonzalez
- Centro Regional de Alergia e Inmunología Clinica, Hospital Universitario “Dr. José Eleuterio González”, Ave. Gonzalitos y Madero, s/n, Colonia Mitras Centro, CP. 64460, Monterrey, Nuevo Leon, Mexico
| | - Rosa Ivett Guzman-Avilan
- Centro Regional de Alergia e Inmunología Clinica, Hospital Universitario “Dr. José Eleuterio González”, Ave. Gonzalitos y Madero, s/n, Colonia Mitras Centro, CP. 64460, Monterrey, Nuevo Leon, Mexico
| | - Jose Ignacio Canseco-Villarreal
- Centro Regional de Alergia e Inmunología Clinica, Hospital Universitario “Dr. José Eleuterio González”, Ave. Gonzalitos y Madero, s/n, Colonia Mitras Centro, CP. 64460, Monterrey, Nuevo Leon, Mexico
| | - Alfredo Arias-Cruz
- Centro Regional de Alergia e Inmunología Clinica, Hospital Universitario “Dr. José Eleuterio González”, Ave. Gonzalitos y Madero, s/n, Colonia Mitras Centro, CP. 64460, Monterrey, Nuevo Leon, Mexico
| |
Collapse
|
5
|
Cherrez-Ojeda I, Maurer M, Bernstein JA, Vanegas E, Felix M, Ramon GD, Ensina LF, Larco Sousa JI, Matos Benavides EE, Cardona Villa R, Latour Staffeld P, Morfin-Maciel BM, Mori J, Wilches C P, Mata VL, Cherrez A. Learnings from real-life experience of using omalizumab for chronic urticaria in Latin America. World Allergy Organ J 2019; 12:100011. [PMID: 30937137 PMCID: PMC6439401 DOI: 10.1016/j.waojou.2019.100011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/20/2018] [Accepted: 01/08/2019] [Indexed: 11/19/2022] Open
Abstract
Background Updated urticaria guidelines recommend that patients should be assessed for disease activity, severity, control, and quality of life at baseline and follow up. Regarding treatment, guidelines consider second generation antihistamines as the cornerstone in therapy for chronic urticaria (CU), while other drugs, such as omalizumab, are conceived as second-line alternatives. In regards to omalizumab, despite advances in the management of CU, there are still open questions about timing, dosing, and objective measures for clinical response. This study was designed to portray the use of patient-reported outcomes (PROs) in chronic urticaria management, as well as the effectiveness and treatment patterns of omalizumab in CU, as seen in a real-life setting in Latin America. Methods This is a retrospective observational study, involving 72 Latin American patients with chronic urticaria treated with omalizumab. Patient reported outcomes and treatment patterns, response, quality of life improvement and discontinuation were analyzed. Results From the 72 patients, 91.7% (n = 66) were assessed through PROs, where urticaria control test (UCT) was the most used (79.2%; n = 57). Overall, 80.0% (n = 44) responded to omalizumab at some point of the treatment. Omalizumab 300 mg was associated with earlier response compared to lower doses. Regardless of dosage, most patients assessed with CU-Q2oL improved quality of life (80.8%; n = 21). With respect to omalizumab discontinuation, 20.8% (n = 15) patients interrupted omalizumab before the 3rd month of treatment (p = .000). Conclusions The present study highlights how the use of PROs and omalizumab in Latin America differ from guidelines' recommendations and clinical trials. Even though most patients were initiated under omalizumab 300 mg, most of them finished with lower doses. Regardless of dosage, most patients responded to omalizumab and improved quality of life at some point during treatment. However, such features were seen earlier with omalizumab 300 mg. Regarding treatment discontinuation, one-fifth of patients interrupted omalizumab before the third month.
Collapse
Key Words
- CU, chronic urticaria
- CU-Q2oL, chronic urticaria quality of life questionnaire
- Chronic spontaneous urticaria
- EAACI/GA2LEN/EDF/WAO, European Academy of Allergology and Clinical Immunology
- Global Allergy and Asthma European Network, European Dermatology Forum and World Allergy Organization
- LA, Latin America
- Latin America
- MCID, minimal clinical important difference
- Omalizumab
- PRO, patient-reported outcomes
- Patient-reported outcomes
- Quality of life
- SD, standard deviation
- UAS7, urticaria activity score 7
- UCT, urticaria control test
Collapse
Affiliation(s)
- Ivan Cherrez-Ojeda
- Universidad Espíritu Santo, Samborondón, Ecuador
- Respiralab, Respiralab Research Group, Guayaquil, Ecuador
- Corresponding author. Iván Chérrez Ojeda, Universidad Espíritu Santo, Km. 2.5 vía La Puntilla, Samborondón, Ecuador. Código postal: 0901-952.
| | - Marcus Maurer
- Department of Dermatology and Allergy, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Jonathan A. Bernstein
- University of Cincinnati College of Medicine, Department of Internal Medicine, Division of Immunology/Allergy Section, Cincinnati, OH, United States
| | - Emanuel Vanegas
- Universidad Espíritu Santo, Samborondón, Ecuador
- Respiralab, Respiralab Research Group, Guayaquil, Ecuador
| | - Miguel Felix
- Universidad Espíritu Santo, Samborondón, Ecuador
- Respiralab, Respiralab Research Group, Guayaquil, Ecuador
| | - German D. Ramon
- Instituto de Alergia e Inmunología del Sur, Bahía Blanca, Prov. de Buenos Aires, Argentina
| | | | | | | | | | - P. Latour Staffeld
- Centro Avanzado de Alergia y Asma de Santo Domingo, Santo Domingo, Dominican Republic
- Universidad Nacional Pedro Henriquez Ureña, Santo Domingo, Dominican Republic
| | | | | | - Paul Wilches C
- Unidad de Asma y Alergia del Hospital Monte Sinai, Cuenca, Ecuador
| | - Valeria L. Mata
- Universidad Espíritu Santo, Samborondón, Ecuador
- Respiralab, Respiralab Research Group, Guayaquil, Ecuador
| | - Annia Cherrez
- Respiralab, Respiralab Research Group, Guayaquil, Ecuador
- University Hospital, Dermatology Department, Rostock, Germany
| |
Collapse
|
6
|
Santiago-Vázquez M, Barrera-Llaurador J, Carrasquillo OY, Sánchez S. Chronic spontaneous urticaria associated with colon adenocarcinoma: A paraneoplastic manifestation? A case report and review of literature. JAAD Case Rep 2018; 5:101-103. [PMID: 30581946 PMCID: PMC6297263 DOI: 10.1016/j.jdcr.2018.10.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Marely Santiago-Vázquez
- Transitional Year Program, University of Puerto Rico School of Medicine, San Juan, Puerto Rico.,Department of Dermatology, University of Puerto Rico, San Juan, Puerto Rico
| | | | | | - Samuel Sánchez
- Department of Dermatology, University of Puerto Rico, San Juan, Puerto Rico
| |
Collapse
|