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Pseudoallergen-Free and Low-Histamine Diet in Adolescents With Chronic Spontaneous Urticaria (PAF-LH-CSU)

2 juni 2026 bijgewerkt door: Ayşe Süleyman, Istanbul University

Clinical Response to a Histamine- and Pseudoallergen-Restricted Diet in Patients With Chronic Urticaria

The goal of this clinical trial is to learn whether a histamine- and pseudoallergen-restricted diet can help reduce symptoms in people with chronic urticaria. It will also learn whether this diet changes the need for urticaria medication.

The main questions it aims to answer are:

Does the diet lower urticaria activity, including hives and itching?

Does the diet improve disease control and quality of life?

Does the diet change the need for urticaria medication?

Which clinical or laboratory factors may affect response to the diet?

There is no comparison group. Researchers will compare participants' symptoms before and after the diet.

Participants will:

Follow a structured histamine- and pseudoallergen-restricted diet

Continue their usual urticaria treatment as recommended by their doctor

Record or report their urticaria symptoms during follow-up

Visit the clinic for assessment of symptoms, disease control, quality of life, medication use, and laboratory findings.

Studie Overzicht

Gedetailleerde beschrijving

Chronic spontaneous urticaria in children is a heterogeneous condition characterized by recurrent wheals, angioedema, or both for more than six weeks without a consistent external trigger. Although second-generation H1-antihistamines are the mainstay of treatment, disease activity may persist in some children despite standard care.

Dietary factors, including histamine-rich foods, histamine-releasing foods, and pseudoallergens such as selected additives, preservatives, colorants, and naturally occurring food components, have been proposed as potential aggravating factors in a subset of patients. However, the clinical value of dietary restriction in pediatric chronic spontaneous urticaria remains uncertain, and better evidence is needed to determine whether a time-limited dietary approach provides additional benefit.

This randomized controlled study will evaluate a structured low-histamine and pseudoallergen-free diet as an adjunct to standard guideline-based care in children with chronic spontaneous urticaria. The comparator group will receive standard care with general age-appropriate healthy eating advice, without specific restriction of histamine-rich or pseudoallergen-containing foods during the primary comparison period.

All participants will continue to receive standard clinical care according to current urticaria management principles. Antihistamine treatment will be permitted according to clinical need. The study will also explore whether baseline clinical and laboratory characteristics, including autologous serum skin test status and routine inflammatory markers, are associated with response to the dietary intervention.

Because this is a pediatric dietary study, the dietary intervention will be standardized, time-limited, and implemented with parental guidance. Unnecessary prolonged dietary restriction will be avoided.

Studietype

Ingrijpend

Inschrijving (Geschat)

120

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

    • Fatih
      • Istanbul, Fatih, Turkije (Türkiye), 34100
        • Istanbul University, Istanbul Faculty of Medicine, Department of Pediatric Allergy and Immunology

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Kind
  • Volwassen

Accepteert gezonde vrijwilligers

Nee

Beschrijving

IInclusion Criteria:

Children aged 1 to 18 years Diagnosis of chronic spontaneous urticaria Disease duration of at least 6 weeks Presence of active urticaria symptoms at enrollment Ability of the child and/or parent/caregiver to complete symptom and diet follow-up forms Ability and willingness of the family to follow the assigned dietary recommendation Written informed consent from parent or legal guardian Assent from the child when applicable

Exclusion Criteria:

Pure chronic inducible urticaria Urticaria secondary to an identified trigger IgE-mediated food allergy requiring a specific elimination diet Active infection or parasitic disease Oral corticosteroid use within the previous 4 weeks Current or recent biological treatment for chronic urticaria Coeliac disease Inflammatory bowel disease Known systemic mast cell disease Severe chronic systemic disease affecting diet, growth, or follow-up Significant malnutrition or a medical condition requiring a special diet Pregnancy or lactation in postmenarchal adolescents Inability or unwillingness of the child or family to adhere to the assigned dietary recommendation Incomplete follow-up data

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Dubbele

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Low-histamine and pseudoallergen-free diet group
Children with chronic spontaneous urticaria assigned to this arm will receive a structured low-histamine and pseudoallergen-free diet in addition to standard guideline-based clinical care.
Participants assigned to the intervention group will receive a structured low-histamine and pseudoallergen-free diet for 4 weeks in addition to standard guideline-based clinical care. The diet will restrict histamine-rich foods, foods considered to promote histamine release, and foods containing common pseudoallergen sources such as selected additives, preservatives, colorants, and naturally occurring pseudoallergen-rich foods. Antihistamine treatment will be permitted according to clinical need.
Actieve vergelijker: General dietary advice control group
Children with chronic spontaneous urticaria assigned to this arm will receive standard guideline-based clinical care with general age-appropriate healthy eating advice, without specific restriction of histamine-rich or pseudoallergen-containing foods during the primary comparison period.
Participants assigned to the control group will receive standard guideline-based clinical care together with general age-appropriate healthy eating advice. No specific restriction of histamine-rich foods, histamine-releasing foods, or pseudoallergen-containing foods will be recommended during the primary 4-week comparison period. Antihistamine treatment will be permitted according to clinical need.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Change in weekly urticaria activity score
Tijdsspanne: Baseline to week 4
Change in weekly urticaria activity score (UAS7) from baseline to week 4 will be compared between the low-histamine and pseudoallergen-free diet group and the general healthy eating advice control group.
Baseline to week 4
Change in urticaria control test score
Tijdsspanne: Baseline to week 4
Change in urticaria control test (UCT) score from baseline to week 4 will be compared between the low-histamine and pseudoallergen-free diet group and the general healthy eating advice control group.
Baseline to week 4

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Change in dermatology quality-of-life score
Tijdsspanne: Baseline to week 4
Change in age-appropriate dermatology quality-of-life score from baseline to week 4 will be compared between the low-histamine and pseudoallergen-free diet group and the general healthy eating advice control group.
Baseline to week 4
Change in antihistamine requirement
Tijdsspanne: Baseline to week 4
Change in antihistamine requirement from baseline to week 4 will be compared between the two study groups. Antihistamine use will be assessed according to the need for standard-dose or increased-dose second-generation H1-antihistamine treatment.
Baseline to week 4
Proportion of participants achieving clinical response
Tijdsspanne: Baseline to week 4
The proportion of participants achieving clinical response at week 4 will be compared between the two study groups. Clinical response will be defined as at least a 50% reduction in weekly urticaria activity score from baseline to week 4.
Baseline to week 4
Dietary adherence
Tijdsspanne: Basaline to week 4.
Adherence to the assigned dietary recommendation will be assessed during the 4-week intervention period using a dietary adherence checklist or dietary diary.
Basaline to week 4.

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Algemene publicaties

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

24 november 2025

Primaire voltooiing (Geschat)

24 november 2026

Studie voltooiing (Geschat)

1 januari 2027

Studieregistratiedata

Eerst ingediend

2 juni 2026

Eerst ingediend dat voldeed aan de QC-criteria

2 juni 2026

Eerst geplaatst (Werkelijk)

8 juni 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

8 juni 2026

Laatste update ingediend die voldeed aan QC-criteria

2 juni 2026

Laatst geverifieerd

1 juni 2026

Meer informatie

Termen gerelateerd aan deze studie

Andere studie-ID-nummers

  • ASST-PAF-LH-CSU-2025-3729877
  • 2025-3729877 (Andere identificatie: Istanbul University, Istanbul Faculty of Medicine Clinical Research Ethics Committee)

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Beschrijving IPD-plan

Individual participant data will not be publicly shared because of privacy and ethical restrictions related to pediatric clinical data. De-identified data may be considered upon reasonable request and subject to approval by the study investigators and relevant institutional authorities.

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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