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Link between low disease activity and complete response to antihistamine in urticaria

antihistamine in urticaria antihistamine in urticaria
antihistamine in urticaria antihistamine in urticaria

The goal of this study was to find out the determinants of a full response to standard-dosed and higher-dosed antihistamine therapy in chronic spontaneous urticaria (CSU)-affected people.

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Key take away

In people with chronic spontaneous urticaria, a complete response to antihistamine therapy is associated with low disease activity.

Background

The goal of this study was to find out the determinants of a full response to standard-dosed and higher-dosed antihistamine therapy in chronic spontaneous urticaria (CSU)-affected people.

Method

Medical records of 475 CSU subjects (120 of whom were under the age of 18) from 3 separate facilities were examined. Based on 17 clinical factors, 15 machine learning models and conventional statistical techniques were employed to predict full response to standard-dose and higher than standard-dose antihistamine therapy.

Result

The urticaria activity score (UAS), which was used to measure CSU disease activity, was the only clinical indicator that could predict for all age groups a full response to standard-dose and higher-than-standard-dose antihistamine therapy using conventional statistics and machine learning models. According to receiver operating characteristic (ROC) studies, for standard-dosed (area under the ROC curve [AUC] = 0.69) and higher than standard-dosed (AUC = 0.79) antihistamine treatments, the ideal cut-off values of disease activity to predict full response was UAS <3 and UAS <4, respectively.

Machine learning models also found lower total immunoglobulin E (IgE < 150 IU/mL) as a predictor of complete response to standard-dose antihistamine therapy and lower C-reactive protein (CRP < 3.4 mg/mL) as a predictor of complete response to higher-dose antihistamine treatment.

Conclusion

Those with a UAS of less than 3 are highly likely to have a complete response to standard-dosed antihistamine therapy, while patients with a UAS of less than 4 are highly likely to have a complete response to higher than standard-dosed antihistamine therapy. With both machine learning models and conventional statistics, low CSU disease activity is the sole constant predictor of a complete response to antihistamine therapy across all age groups.

Source:

International Archives of Allergy and Immunology

Article:

In Chronic Spontaneous Urticaria, Complete Response to Antihistamine Treatment Is Linked to Low Disease Activity

Authors:

Türk M. et al.

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