Patients With Chronic Spontaneous Urticaria Who Have Wheals, Angioedema, or Both, Differ Demographically, Clinically, and in Response to Treatment-Results From CURE

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Riccardo Asero - (Author)
  • Andrea Bauer - , Department of Dermatology (Author)
  • Mojca Bizjak - (Author)
  • Laurence Bouillet - (Author)
  • Daria Fomina - (Author)
  • Clive Grattan - (Author)
  • Alicja Kasperska-Zajac - (Author)
  • Emek Kocatürk - (Author)
  • Michael Makris - (Author)
  • Pavel Kolkhir - (Author)

Abstract

BACKGROUND: Patients with chronic spontaneous urticaria (CSU) have spontaneous wheals (W), angioedema (AE), or both, for longer than 6 weeks. Clinical differences between patients with standalone W, standalone AE, and W and AE (W+AE) remain incompletely understood.

OBJECTIVE: To compare W, AE, and W+AE CSU patients regarding demographics, disease characteristics, comorbidities, disease burden, and treatment response.

METHODS: Baseline data from 3,698 CSU patients in the ongoing, prospective, international, multicenter, observational Chronic Urticaria REgistry (CURE) were analyzed (data cut: September 2022).

RESULTS: Across all CSU patients, 59%, 36%, and 5% had W+AE, W, and AE, respectively. The W+AE patients, compared with W and AE patients, showed the lowest male-to-female ratio (0.33), higher rates of concomitant psychiatric disease (17% vs 11% vs 6%, respectively), autoimmune disease (13% vs 7% vs 9%, respectively), and nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity (9% vs 5% vs 2%, respectively) and the highest disease impact. The W patients, compared with W+AE and AE patients, showed the lowest rates of concomitant hypertension (15% vs 21% vs 40%, respectively) and obesity (11% vs 16% vs 17%, respectively), the highest rate of concomitant inducible urticaria (24% vs 22% vs 6%, respectively), and shorter W duration. The AE patients, compared with W+AE and W patients, were older at disease onset, showed longer AE duration, and the best response to increased doses of H1-antihistamines (58% vs 24% vs 31%, respectively) and omalizumab (92% vs 67% vs 60%, respectively).

CONCLUSIONS: Our findings provide a better understanding of CSU phenotypes and may guide patient care and research efforts that aim to link them to pathogenic drivers.

Details

Original languageEnglish
Pages (from-to)3515-3525.e4
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume11
Issue number11
Publication statusPublished - Nov 2023
Peer-reviewedYes

External IDs

ORCID /0000-0002-4411-3088/work/151982502
Scopus 85169512340

Keywords

Sustainable Development Goals

Keywords

  • Angioedema/drug therapy, Anti-Allergic Agents/therapeutic use, Chronic Disease, Chronic Urticaria/drug therapy, Female, Humans, Male, Omalizumab/therapeutic use, Prospective Studies, Urticaria/drug therapy