Clinical experience of a chronic urticaria referral university center

Objective. Describing routine procedures, clinical profile and evolution of patients treated in a chronic urticaria (CU) reference center of a university hospital. Methods. Retrospective analysis of clinical records and database of CU patients registered between March 2011 and February 2016 in a reference center. Besides demographic characteristics, disease duration, comorbidities, angioedema, thyroid lab tests, urticaria subtypes, provocation tests, UAS and CUQ2oL scores were recorded. Patients with 3 or more visits were included in analysis regarding the first and last visits, to evaluate pharmacological treatment and differences of UAS/ CUQ2oL scores, antihistamines (anti-H1) dosages and need of other medications, according urticaria subtypes. Results. During the study, 252 patients were attended, 200 with CU, including 162 women, median age 45 years (perc 25 - 75 = 27 - 58) and median duration of symptoms before diagnosis 24 months (perc 25 - 75 = 9 - 60). Regarding the etiology, 166 (83%) patients had chronic spontaneous urticaria (CSU), 34 (17%) had isolated chronic inducible urticaria (CIndU) and 66 (33%), CSU with CIndU. Among the 123 patients followed up for 3 or more visits, first prescription to 106 (86.2%) patients was monotherapy with anti-H1, and associations with other medications were prescribed to 17 (13.8%). At the last visit, 94 (76.5%) received antihistamines, and 29 (23.5%) used associations. Patients with CSU + CIndU + ASST positive need more association of anti-H1 with other medications than patients with CSU + CIndU and only CIndU (chi 2 = 7.998; p 0.01). Between first and last visits, CUQ2oL mean scores changed from 35.7 (+/- 21.9) to 22.6 (+/- 21.0) (Z = -4.833 p < 0.000). Conclusions. Most of the patients presented CSU, frequently associated with CIndU. There was an improvement in the patients' quality of life during the follow-up period. All patients were treated with antihistamines and there was a great need for doses above the standardized and also for combination with other medications, especially in patients with concomitance of urticaria subtypes..