Certain biomarkers in patients with chronic spontaneous urticaria (CSU) may predict the treatment response to different therapeutic options. This was the result of a single-centre, retrospective study in children with CSU that won the second poster prize at the 2023 American Academy of Dermatology annual meeting.

Information on biomarkers for chronic spontaneous urticaria (CSU) in children is sparse, according to Alex Nguyen, MSc, who sought to better understand the role of different biomarkers in treatment response and disease resolution in children with CSU. He presented his finding at the 2023 American Academy of Dermatology annual meeting.1

Data from 109 children from the Montreal Children’s Hospital Allergy and Immunology Clinic who reported hives for at least 6 weeks from 2013 to 2022 were included (mean age, 9; 55% girls). They obtained levels of anti-thyroxine peroxidase (anti-TPO), thyroid stimulating hormone (TSH), total immunoglobulin E (IgE), CD63, tryptase, eosinophils, platelets, and mean platelet volume (MPV). The weekly urticaria activity score (UAS7) was used to record diseases activity at study entry.

Possible influences of these biomarkers on the following treatments were assessed: omalizumab, antihistamines at standard dose, four times the standard dose, and resolution of treatment. Univariate and multivariate logistic regressions were used to determine factors associated with different treatment levels and resolutions.

According to the results of the univariate analysis, elevated levels of MPV were linked with the four times increased dose of antihistamines treatment level whereas younger age was linked with disease resolution. Elevated tryptase was associated with antihistamines use at the standard dose (OR, 1.152; 95%CI, 1.019-1.302) and lower tryptase levels with disease resolution (OR, 0.861; 95% CI,  0.777‒0.955) after adjustment for different factors (eg, age, sex TSH, anti-TPO, total IgE, CD63, eosinophils, MPV, and platelets in the multivariate analysis).

Although these results should be confirmed in a larger study, the authors conclude that assessment of biomarkers in pediatric patients with CSU may be useful to identify the response to different treatment options.

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