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ENGLISH ABSTRACT
慢性自发性荨麻疹达标治疗专家共识（2023）
中华医学会皮肤性病学分会
中国医师协会皮肤科医师分会
作者及单位信息
·
DOI： 10.35541/cjd.20230004
Expert consensus on treat-to-target in chronic spontaneous urticaria (2023)
Chinese Society of Dermatology
China Dermatologist Association
Xiao Ting
Zhao Zuotao
Gao Xinghua
Authors Info & Affiliations
Chinese Society of Dermatology
China Dermatologist Association
Xiao Ting
Zhao Zuotao
Gao Xinghua
·
DOI： 10.35541/cjd.20230004
5899
2027
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摘要

慢性自发性荨麻疹（CSU）是慢性荨麻疹中最常见的表型。标准剂量、加量或联合的二代抗组胺药是CSU的治疗选择，但约50%的患者对抗组胺治疗抵抗。达标治疗已被证实可提升慢性疾病的管理质量，但目前国内尚未提出CSU达标治疗的理念。我国荨麻疹诊疗及相关领域的31位专家基于国内外最新指南、共识及临床研究、真实世界研究进展，结合专家经验，共同制订CSU达标治疗共识，为临床医生提供指导。

视频摘要
慢性自发性荨麻疹达标治疗专家共识（2023）
荨麻疹;慢性自发性荨麻疹;达标治疗;专家共识
ABSTRACT

Chronic spontaneous urticaria (CSU) is the most common phenotype of chronic urticaria. Liscenced-dosed, up-dosed, or combined second-generation H1-antihistamines are choices for the treatment of CSU. However, approximately 50% of patients with CSU are resistant to antihistamine therapies. The treat-to-target approach has been proven to improve the quality of chronic disease management, but has not been proposed in CSU in China so far. Based on the latest guidelines, consensus, clinical trials and real-world studies in China and other countries, and combined with experts′ clinical experience, 31 Chinese experts in the field of urticaria diagnosis and treatment and related fields developed this consensus on treat-to-target in CSU, aiming to provide detailed guidance to clinicians.

Urticaria;Chronic spontaneous urticaria;Treat-to-target;Consensus
Xiao Ting, Email: mocdef.6ab21txumc
Zhao Zuotao, Email: mocdef.3ab61oatoatouzoahz
Gao Xinghua, Email: mocdef.labiamtohyrraboag
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引用本文

中华医学会皮肤性病学分会,中国医师协会皮肤科医师分会. 慢性自发性荨麻疹达标治疗专家共识（2023）[J]. 中华皮肤科杂志,2023,56(06)：489-495.

DOI:10.35541/cjd.20230004

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荨麻疹是一种以风团伴或不伴血管性水肿为特点的肥大细胞介导性疾病，病程超过6周的称为慢性荨麻疹（chronic urticaria，CU） [ 1 ]。根据有无特定诱发因素，CU分为慢性自发性荨麻疹（chronic spontaneous urticaria，CSU）和慢性诱导性荨麻疹。CSU约占CU的60% ~ 90% [ 1 , 2 ]。
CSU好发于30岁以上青中年人群，女性多于男性。2011年，欧洲报告的CSU点患病率为0.5% ~ 1.0% [ 3 ]。2006—2014年，韩国报告的年龄校正后CSU患病率为0.16% ~ 0.45% [ 4 ]。2019年，我国报告的新入学大学生中CSU患者比例为2.7% [ 5 ]。CSU严重影响患者的睡眠等生活质量 [ 6 ]，长期治疗给患者和社会造成了沉重的经济负担 [ 7 , 8 , 9 ]。标准剂量、加量或联合的二代抗组胺药是CSU的治疗选择。但二代抗组胺药物治疗1年后，仍有高达42.2%的患者未得到有效控制 [ 10 ]。完全控制症状或降低发作频率、缩短发作持续时间是CSU患者最迫切的治疗需求。近年来，奥马珠单抗的应用使越来越多的难治性CSU患者达到完全控制和缓解。对抗组胺药治疗效果不佳的CSU患者迫切需要更新治疗理念，尽早升级治疗，达到完全控制病情。
达标治疗（treat-to-target）指的是未达到既定目标之前，治疗逐步升级，直至达到目标。达标治疗是一种设计治疗策略，核心是在疾病管理中进行严格的控制，在有限的时间窗内达到预定的治疗目标，实施要点是基于标准化的定期疾病评估，从而对治疗方案进行及时、动态地调整。达标治疗理念已成功应用于慢性炎症性皮肤病（如银屑病和特应性皮炎）及自身免疫病（如类风湿关节炎和系统性红斑狼疮）等的管理，并已被证实对改善这些疾病的结局起到了重要作用 [ 11 , 12 , 13 , 14 , 15 ]。此次，我们将达标治疗理念引入CSU的治疗，希望能为临床医师规范治疗和管理CSU患者提供指导。
本共识邀请了国内31名荨麻疹诊疗及相关领域皮肤病学专家讨论制订。本共识形成分为以下步骤：第1次讨论，回顾近年来发表的国内外CSU相关指南、共识、临床研究、真实世界研究，特别是与临床研究主要和次要疗效终点、病情评估和诊疗路径相关的内容，结合专家经验，汇总专家观点，形成共识初稿；第2次讨论，讨论共识初稿，提出修改意见；第3次讨论，汇总前期讨论结果，修改共识方案，重点讨论争议点，最终形成共识。
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备注信息
A
肖汀，Email： mocdef.6ab21txumc
B
赵作涛，Email： mocdef.3ab61oatoatouzoahz
C
高兴华，Email： mocdef.labiamtohyrraboag
D
参与制订本共识的所有专家均坚持客观公正的立场，所持观点未受任何企业的影响，所有专家均声明无利益冲突
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