Effectiveness of Hydroxychloroquine and Omalizumab in Chronic Spontaneous Urticaria: A Real-World Study.

BACKGROUND: Chronic spontaneous urticaria (CSU) not controlled by optimized doses of antihistamines is referred to as refractory CSU. Add-on therapies recommended by guidelines include omalizumab, immunosuppressive, and anti-inflammatory agents. OBJECTIVES: The objective of the study was to assess the real-world effectiveness of different add-on treatment options for refractory CSU in 2 large clinical practices. METHODS: A retrospective chart review was conducted in 264 patients with refractory CSU not adequately controlled for ≥6 weeks with optimized doses of second-generation histamine-1 blockers. Omalizumab and hydroxychloroquine were the most frequently prescribed add-on therapies, allowing comparisons of clinical outcomes for these 2 agents. Complete response included absent or infrequent urticaria and patient satisfaction with treatment. Partial response was reduced hives, but requiring a second add-on therapy. Sustained response was complete response to an add-on therapy for ≥1 year. RESULTS: Omalizumab add-on treatment was significantly more likely to be associated with a complete response versus hydroxychloroquine. Complete sustained response at 1 year was observed in 82% (111 of 134) of patients on omalizumab and 66% (73 of 111) on hydroxychloroquine as the first add-on therapy (P < .01). Patients with thyroid disease had a poorer response to add-on treatments (45% responded vs 63%; P = .03). In patients with incomplete responses to first add-on interventions (n = 45), 65% and 62% subsequently had complete responses to omalizumab and hydroxychloroquine, respectively. CONCLUSIONS: Although omalizumab was superior, hydroxychloroquine achieved a complete response in two-thirds of treated patients. Given a favorable safety profile, hydroxychloroquine should be considered as an add-on treatment for refractory CSU.

Be yourself, believe in yourself, and be happy: self-efficacy as a mediator between personality factors and subjective well-being.

Research has shown close connections between personality and subjective well-being (SWB), suggesting that personality traits predispose individuals to experience different levels of SWB. Moreover, numerous studies have shown that self-efficacy is related to both personality factors and SWB. Extending previous research, we show that general self-efficacy functionally connects personality factors and two components of SWB (life satisfaction and subjective happiness). Our results demonstrate the mediating role of self-efficacy in linking personality factors and SWB. Consistent with our expectations, the influence of neuroticism, extraversion, openness, and conscientiousness on life satisfaction was mediated by self-efficacy. Furthermore, self-efficacy mediated the influence of openness and conscientiousness, but not that of neuroticism and extraversion, on subjective happiness. Results highlight the importance of cognitive beliefs in functionally linking personality traits and SWB.

On the incremental validity of irrational beliefs to predict subjective well-being while controlling for personality factors.

This research examines the incremental validity of irrational thinking as conceptualized by Albert Ellis to predict diverse aspects of subjective well-being while controlling for the influence of personality factors. Rational-emotive behavior therapy (REBT) argues that irrational beliefs result in maladaptive emotions leading to reduced well-being. Although there is some early scientific evidence for this relation, it has never been investigated whether this connection would still persist when statistically controlling for the Big Five personality factors, which were consistently found to be important determinants of well-being. Regression analyses revealed significant incremental validity of irrationality over personality factors when predicting life satisfaction, but not when predicting subjective happiness. Results are discussed with respect to conceptual differences between these two aspects of subjective well-being.

On the incremental validity of irrational beliefs to predict subjective well-being while controlling for personality factors / Sobre la creciente validez de las creencias irracionales a la hora de predecir el bienestar subjetivo a la vez que se controlan los factores de personalidad

This research examines the incremental validity of irrational thinking as conceptualized by Albert Ellis to predict diverse aspects of subjective well-being while controlling for the influence of personality factors. Rational-emotive behavior therapy (REBT) argues that irrational beliefs result in maladaptive emotions leading to reduced well-being. Although there is some early scientific evidence for this relation, it has never been investigated whether this connection would still persist when statistically controlling for the Big Five personality factors, which were consistently found to be important determinants of well-being. Regression analyses revealed significant incremental validity of irrationality over personality factors when predicting life satisfaction, but not when predicting subjective happiness. Results are discussed with respect to conceptual differences between these two aspects of subjective well-being (AU)

Este estudio examina la creciente validez del pensamiento irracional tal y como lo describió Albert Ellis a la hora de predecir los distintos aspectos del bienestar subjetivo a la vez que se controla la influencia de los factores de personalidad. La terapia racional-emotiva conductual (TREC) se basa en que las creencias irracionales tienen como resultado emociones de inadaptabilidad que llevan a un menor bienestar. A pesar de que hay algunas primeras pruebas científicas indicando esta relación, nunca se ha investigado si esta conexión persistiría si a la vez se controlan estadísticamente los «Big Five personality factors», que se descubrió que eran determinantes para el bienestar. Los análisis de regresión han revelado un incremento significativo en la validez de la irracionalidad por encima de los factores a la hora de predecir la satisfacción en la vida, pero no a la hora de predecir la felicidad subjetiva. Los desacuerdos respecto a estos resultados se basan en las diferencias conceptuales entre estos dos aspectos del bienestar subjetivo (AU)