Premium
Chronic spontaneous urticaria in children ‐ a systematic review on interventions and comorbidities
Author(s) -
Cornillier Hélène,
Giraudeau Bruno,
Munck Stéphane,
Hacard Florence,
JonvilleBera AnniePierre,
d'Acremont Gwenaëlle,
Pham BachNga,
Maruani Annabel
Publication year - 2018
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/pai.12870
Subject(s) - medicine , randomized controlled trial , pediatrics , medline , adverse effect , political science , law
Abstract Background Chronic spontaneous urticaria ( CSU ) is not frequent in children. Management guidelines have been developed for adults and randomized controlled trials ( RCT s) included teenagers aged 12‐18, but data for children under age 12 are limited. We performed a systematic review to assess comorbidities in children <12 years old with CSU and the efficacy and safety of treatments. Methods We searched for original articles of epidemiologic and treatment data in children <12 years old with CSU that were published from 2005 to July 2016 in MEDLINE , EMBASE , CENTRAL , and LILACS . Article selection and data extraction were performed in duplicate. Results Our systematic review included 9 reports on epidemiologic data (633 children). Five comorbidities and laboratory anomalies associated with CSU found were atopy (28.1%), positive autologous serum skin test (36.8%), thyroid biologic anomalies (6.4%) and detectable antinuclear antigen (10.4%), seroprevalence for Helicobacter pylori (21.1%), low vitamin D level (69.1%), and psychiatric disorders (70.4%). Only one study allowed for comparison with a control group. Our review included 10 studies (322 children), describing 5 different drug families, mostly H1‐antihistamines (n = 297). One randomized controlled study compared single‐dose rupatadine with single‐dose desloratadine and placebo. Cyclosporine was effective and had no adverse effects in 18 children. Omalizumab, montelukast, and cefuroxime were reported in very small series (5, 1, and 1 patients). Conclusions H1‐antihistamines are effective for CSU in children <12 years old, with reassuring safety data at licensed doses. Cyclosporine seems effective, but the level of evidence is low.