Observational Study

. 2023 Nov;11(11):3515-3525.e4.

doi: 10.1016/j.jaip.2023.08.020. Epub 2023 Aug 19.

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

Thomas Buttgereit¹, Carolina Vera¹, Felix Aulenbacher¹, Martin K Church¹, Tomasz Hawro², Riccardo Asero³, Andrea Bauer⁴, Mojca Bizjak⁵, Laurence Bouillet⁶, Joachim Dissemond⁷, Daria Fomina⁸, Ana M Giménez-Arnau⁹, Clive Grattan¹⁰, Stamatios Gregoriou¹¹, Kanokvalai Kulthanan¹², Alicja Kasperska-Zajac¹³, Emek Kocatürk¹⁴, Michael Makris¹⁵, Pavel Kolkhir¹, Karsten Weller¹, Markus Magerl¹, Marcus Maurer¹⁶

Affiliations

¹ Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Institute of Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), Allergology and Immunology, Berlin, Germany.
² Institute and Comprehensive Center for Inflammation Medicine, Department of Dermatology, Allergology and Venerology, University Medical Center Schleswig-Holstein, Lübeck, Germany.
³ Department of Allergology, Clinica San Carlo, Paderno Dugnano, Milan, Italy.
⁴ Department of Dermatology, University Hospital, Carl Gustav Carus, Technical University Dresden, Dresden, Germany.
⁵ Division of Allergy, University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia.
⁶ CREAK (Centre national de référence des angioedèmes), Internal Medicine, CHU Grenobles Alpes, Grenoble, France.
⁷ Department of Dermatology, Venerology and Allergology, University of Essen, Essen, Germany.
⁸ Center of Allergy and Immunology, Clinical State Hospital 52, Moscow Healthcare Ministry, Moscow, Russian Federation; I. M. Sechenov First Moscow State Medical University (Sechenov University), Department of Clinical Immunology and Allergology, Moscow, Russian Federation.
⁹ Department of Dermatology, Institut Mar de Investigacions Mèdiques, Universitat Pompeu Fabra, Barcelona, Spain.
¹⁰ Guy's Hospital, St. John's Institute of Dermatology, London, UK.
¹¹ National and Kapodistrian University of Athens, 1st Department of Dermatology-Venereology, Andreas Sygros Hospital. Athens, Greece.
¹² Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
¹³ European Center for Diagnosis and Treatment of Urticaria/Angioedema (GA(2)LEN UCARE Network), Medical University of Silesia in Katowice, Katowice, Poland.
¹⁴ Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Institute of Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), Allergology and Immunology, Berlin, Germany; Department of Dermatology, Koç University School of Medicine, Istanbul, Turkey.
¹⁵ Allergy Unit "D. Kalogeromitros", 2nd Department, Dermatology and Venereology, National and Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece.
¹⁶ Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Institute of Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), Allergology and Immunology, Berlin, Germany. Electronic address: marcus.maurer@charite.de.

PMID: 37604426
DOI: 10.1016/j.jaip.2023.08.020

Observational Study

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

Thomas Buttgereit et al. J Allergy Clin Immunol Pract. 2023 Nov.

. 2023 Nov;11(11):3515-3525.e4.

doi: 10.1016/j.jaip.2023.08.020. Epub 2023 Aug 19.

Authors

Affiliations

¹ Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Institute of Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), Allergology and Immunology, Berlin, Germany.
² Institute and Comprehensive Center for Inflammation Medicine, Department of Dermatology, Allergology and Venerology, University Medical Center Schleswig-Holstein, Lübeck, Germany.
³ Department of Allergology, Clinica San Carlo, Paderno Dugnano, Milan, Italy.
⁴ Department of Dermatology, University Hospital, Carl Gustav Carus, Technical University Dresden, Dresden, Germany.
⁵ Division of Allergy, University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia.
⁶ CREAK (Centre national de référence des angioedèmes), Internal Medicine, CHU Grenobles Alpes, Grenoble, France.
⁷ Department of Dermatology, Venerology and Allergology, University of Essen, Essen, Germany.
⁸ Center of Allergy and Immunology, Clinical State Hospital 52, Moscow Healthcare Ministry, Moscow, Russian Federation; I. M. Sechenov First Moscow State Medical University (Sechenov University), Department of Clinical Immunology and Allergology, Moscow, Russian Federation.
⁹ Department of Dermatology, Institut Mar de Investigacions Mèdiques, Universitat Pompeu Fabra, Barcelona, Spain.
¹⁰ Guy's Hospital, St. John's Institute of Dermatology, London, UK.
¹¹ National and Kapodistrian University of Athens, 1st Department of Dermatology-Venereology, Andreas Sygros Hospital. Athens, Greece.
¹² Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
¹³ European Center for Diagnosis and Treatment of Urticaria/Angioedema (GA(2)LEN UCARE Network), Medical University of Silesia in Katowice, Katowice, Poland.
¹⁴ Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Institute of Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), Allergology and Immunology, Berlin, Germany; Department of Dermatology, Koç University School of Medicine, Istanbul, Turkey.
¹⁵ Allergy Unit "D. Kalogeromitros", 2nd Department, Dermatology and Venereology, National and Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece.
¹⁶ Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Institute of Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), Allergology and Immunology, Berlin, Germany. Electronic address: marcus.maurer@charite.de.

PMID: 37604426
DOI: 10.1016/j.jaip.2023.08.020

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.

Keywords: Angioedema; CSU; CURE registry; Chronic spontaneous urticaria; Recurrent; Without wheals.

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

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

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