A European survey of management approaches in chronic urticaria in
children: EAACI Paediatric Urticaria Taskforce
Abstract
Background: Although well described in adults, there are scarce and
heterogeneous data on the diagnosis and management of chronic urticaria
(CU) in children (0-18 years) throughout Europe. Our aim was to explore
country differences and identify the extent to which the
EAACI/GA²LEN/EDF/WAO guideline recommendations for paediatric urticaria
are implemented. Methods: The EAACI Taskforce for paediatric CU
disseminated an online clinical survey among EAACI paediatric section
members. Members were asked to answer 35 multiple choice questions on
current practices in their respective centres. Results: The survey was
sent to 2,773 physicians of whom 358 (13.8%) responded, mainly
paediatric allergists (80%) and paediatricians (49.7%), working in 69
countries. For diagnosis, Southern European countries used significantly
more routine tests (e.g., autoimmune testing, allergological tests, and
parasitic investigation) than Northern European countries. Most
respondents (60.3%) used a 2nd generation antihistamine as first- line
treatment of whom 64.8% up dosed as a second- line. Omalizumab, was
used as a second line treatment by 1.7% and third-line by 20.7% of
respondents. Most clinicians (65%) follow EAACI/WAO/GA2LEN/EDF
guidelines when diagnosing CU, and only 7.3% follow no specific
guidelines. Some clinicians prefer to follow national guidelines
(18.4%, mainly Northern European) or the AAAAI practice parameter
(1.7%). Conclusions: Even though most members of the Paediatric Section
of EAACI are familiar with the EAACI/WAO/GA2LEN/EDF guidelines, a
significant number do not follow them. Also, the large variation in
diagnosis and treatment strengthens the need to re-evaluate, update and
standardize guidelines on the diagnosis and management of CU in
children.