Analysis of changes in the new edition of the European Clinical Guidelines on urticaria 2020 revision

The current European Clinical Guidelines on urticaria have been initiated by the European Academy of Allergy and Clinical Immunology (EAACI), Dermatology Section of the EAACI, Global Allergy and Asthma European Network, Urticaria and Angioedema Centers of Reference and Excellence, European Dermatology Forum (EuroGuiDerm), Asia Pacific Association of Allergy, and Asthma and Clinical immunology (Asia Pacific Association of Allergy, Asthma and Clinical Immunology). These guidelines have been adopted by the European Union of Medical Specialists. The purpose of the manual is to define and categorize urticaria (with the focus on chronic urticaria), causes, triggers, comorbidities, and burden on patients and society to present the latest advances in the diagnosis and management of patients with chronic urticaria.

This study analyzes the changes in the new edition of the European Clinical Guidelines on urticaria 2020 revision. The changes relate to expanding the goals of the diagnostic examination of patients and quantity of mandatory examinations. The level of persuasiveness of recommendations for assessing the activity and control of chronic spontaneous urticaria and the impact of the disease on the quality of life of patients has been increased. Treatment should correspond to the level of control of the disease and change according to the principle “assess–act–adjust.” In the new edition, the scheme of the stepwise approach to the treatment of urticaria has been changed: the first line is combined with the second. A significant change is the recommendation to increase the dose of omalizumab to 600 mg and reduce the interval to 2 weeks in patients with insufficient response.

The purpose of creating clinical guidelines is to provide information support for physicians to make decisions that improve the quality of medical care for the patient with a particular disease/condition/syndrome, taking into account the latest clinical data and principles of evidence-based medicine.