Conflict of interest The authors disclose the following relevant interactions with pharmaceutical industry: K. Weller: The author declares that he is or recently was compensated for educational lectures by Essex Pharma (now MSD), Novartis and UCB. N. Schoepke: None. K. Krause: The author declares that she is or recently was compensated for educational lectures by Novartis and Uriach. E. Ardelean: None. M. Bräutigam: The author is employee at Novartis Pharma GmbH. M. Maurer: The author declares that he is or recently was a Speaker and/or Advisor for Almirall Hermal, Essex Pharma, Merckle Recordati, Novartis, Sanofi Aventis, Schering-Plough, MSD, Merck, UCB, and Uriach.
Selected urticaria patients benefit from a referral to tertiary care centres – results of an expert survey
Article first published online: 17 DEC 2011
© 2011 The Authors. Journal of the European Academy of Dermatology and Venereology © 2011 European Academy of Dermatology and Venereology
Journal of the European Academy of Dermatology and Venereology
Volume 27, Issue 1, pages e8–e16, January 2013
How to Cite
Weller, K., Schoepke, N., Krause, K., Ardelean, E., Bräutigam, M. and Maurer, M. (2013), Selected urticaria patients benefit from a referral to tertiary care centres – results of an expert survey. Journal of the European Academy of Dermatology and Venereology, 27: e8–e16. doi: 10.1111/j.1468-3083.2011.04387.x
Funding sources This work was supported by the Urtikaria Network e.V. (UNEV) and Novartis Pharma. The company did not influence the way of data presentation in this work.
- Issue published online: 18 DEC 2012
- Article first published online: 17 DEC 2011
- Received: 14 July 2011; Accepted: 17 November 2011
Background Urticaria is a frequent reason for consultations. Recently, it has been demonstrated that the management of chronic spontaneous urticaria (csU) in the practice setting does not fully comply with published guidelines. In addition, it was shown that one of four csU patients is referred to specialized centres.
Objective To analyse the management of urticaria patients in tertiary referral centres.
Methods During a standardized expert-to-expert interview, 41 specialists from German tertiary care centres were asked for different aspects of urticaria patient care with a special focus on csU.
Results On average, the participating centres saw 25 csU patients per month. All ran programmes for the identification of underlying causes with an average success rate of 45 ± 3% which is considerably higher as has been found in the practice setting. In those patients where an identification succeeds, infections, drugs, intolerance and autoreactivity were reported to be causes in 41%, 20%, 17% and 16%. In their symptomatic treatment the majority of centres (71%) followed the guidelines by using regular dosed non-sedating H1-antihistamines as first line and higher doses (61%) as second line option. In contrast to the practice setting, meaningful experience also existed for alternative therapies in antihistamine-resistant patients, such as dapsone, cyclosporin and omalizumab. The expenditure of time, laboratory costs and frequency of follow-up visits was reported to be above average in case of csU.
Conclusion This study indicates that some urticaria patients, especially those with unknown causes or with an H1-antihistamine-resistant disease, may benefit from a referral to tertiary care centres.