Prevalence, Management, and Anaphylaxis Risk of Cold Urticaria: A Systematic Review and Meta-Analysis.

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  • Additional Information
    • Source:
      Publisher: Elsevier Inc Country of Publication: United States NLM ID: 101597220 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2213-2201 (Electronic) NLM ISO Abbreviation: J Allergy Clin Immunol Pract Subsets: MEDLINE
    • Publication Information:
      Original Publication: New York, NY : Elsevier Inc., [2013]-
    • Subject Terms:
      Anaphylaxis*/drug therapy ; Anaphylaxis*/epidemiology ; Chronic Urticaria* ; Urticaria*/drug therapy ; Urticaria*/epidemiology; Chronic Disease ; Humans ; Omalizumab/therapeutic use ; Prevalence
    • Abstract:
      Background: Cold urticaria is a subtype of chronic inducible urticaria (CIndU) associated with significant morbidity and a risk for anaphylaxis. Few studies have assessed the prevalence, management, and prevalence of associated anaphylaxis of cold urticaria.
      Objectives: To evaluate the prevalence of cold urticaria among CIndU and chronic urticaria (CU) cases, to assess the management of cold urticaria, and to determine the prevalence of associated anaphylaxis.
      Methods: We searched PubMed and EMBASE for studies pertaining to cold urticaria and/or CIndU published in the past 10 years. We conducted meta-analyses to evaluate the prevalence of cold urticaria among CIndU and CU cases, the management of cold urticaria with H1-antihistamines and omalizumab, and the prevalence of associated anaphylaxis.
      Results: Twenty-two studies were included in the systematic review and 14 in the meta-analysis. The pooled prevalence of cold urticaria among patients with CU and CIndU was 7.62% (95% confidence interval [CI], 3.45% to 15.99%; I 2  = 98%) and 26.10% (95% CI, 14.17% to 43.05%; I 2  = 97%), respectively. Cold urticaria was managed by H1-antihistamines in 95.67% (95% CI, 92.47% to 97.54%; I 2  = 38%) of patients and omalizumab in 5.95% (95% CI , 2.55% to 13.27%; I 2  = 83%) of patients. The pooled prevalence of anaphylaxis among patients with cold urticaria was 21.49% (95% CI, 15.79% to 28.54%; I 2  = 69%).
      Conclusions: Cold urticaria constitutes an appreciable proportion of CIndU and CU cases and is predominantly managed with H1-antihistamines; few patients receive omalizumab. Anaphylaxis is common, and an epinephrine autoinjector prescription may be considered.
      (Copyright © 2021 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)
    • Contributed Indexing:
      Keywords: Anaphylaxis; Chronic inducible urticaria; Chronic urticaria; Cold contact urticaria; Cold urticaria; Cold-induced urticaria; Physical urticaria; Urticaria
    • Accession Number:
      2P471X1Z11 (Omalizumab)
    • Publication Date:
      Date Created: 20211021 Date Completed: 20220218 Latest Revision: 20220218
    • Publication Date:
      20231215
    • Accession Number:
      10.1016/j.jaip.2021.10.012
    • Accession Number:
      34673287