Systematic review and network meta-analysis of the efficacy and safety of systemic treatments in patients affected by chronic urticaria.

Systematic review and network meta-analysis of the efficacy and safety of systemic treatments in patients affected by chronic urticaria.

Background: Urticaria, colloquially referred to as hives, welts, or wheals, is an inflammatory skin condition characterized by transient pruritic wheals or welts. Urticaria persisting beyond six weeks is defined as chronic urticaria. Often, the cause of chronic hives isn't clear. Chronic urticaria is highly distressing to patients and can be life-threatening. Despite a variety of available treatments, credible guidelines addressing how to achieve optimal patient outcomes are lacking.Methods: Partnering with the American Academy of Allergy, Asthma & Immunology (AAAAI ) / American College of Allergy Asthma and Immunology (ACAAI), the preeminent allergy society worldwide, we will bring together urticaria experts, front-line clinicians, and patients to develop guideline recommendations. This includes priority setting, addressing conflict of interest, and conducting multiple systematic reviews addressing the comparative efficacy and safety of treatments, such as antihistamines (A type of drug that blocks the action of histamines, which can cause fever, itching, sneezing, a runny nose, and watery eyes), biologics (a diverse group of medicines which includes vaccines, growth factors, immune modulators, monoclonal antibodies, as well as products derived from human blood and plasma), and immunomodulators (medicines that change your immune system so it works more effectively) for patient-important outcomes, and patient values and preferences. We will use the Grading of Recommendations Assessment, Development and Evaluation (GRADE, a method of assessing the certainty in evidence and the strength of recommendations in health care), and McMaster-Guidelines International Network (GIN, a comprehensive list of topics and items outlining the practical steps to consider for developing guidelines) approaches to produce structured interpretations of the evidence and translate them into robust recommendations.Impact: This project will create the first trustworthy urticaria guidelines and could improve outcomes internationally.

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