Parameters Linked With Higher Itch Severity in Chronic Spontaneous Urticaria-Chronic Urticaria Registry Results

Jules Stolz¹, Pascale Salameh², Riccardo Asero³, Emek Kocatürk⁴, Jonny Peter⁵, Clive Grattan⁶, Leonie Shirin Herzog¹, Melba Muñoz¹, Joachim Dissemond⁷, Petra Staubach-Renz⁸, Andrea Bauer⁹, Simon Francis Thomsen¹⁰, Ana M Giménez-Arnau¹¹, Maria Puertolas¹¹, Alexis Bocquet¹², Michael Makris¹³, Stamatios Gregoriou¹⁴, Maryam Khoshkhui¹⁵, Samaneh Kouzegaran¹⁶, Martijn Bastiaan Adriaan van Doorn¹⁷, Alicja Kasperska-Zajac¹⁸, Maciej Gąsior¹⁸, Magdalena Zając¹⁸, Elena Latysheva¹⁹, Daria Fomina²⁰, Elena Kovalkova²¹, Gerelma Andrenova²¹, Elizaveta Sedova²¹, Alexandr Vitchuk²², Mojca Bizjak²³, Mitja Košnik²⁴, Kanokvalai Kulthanan²⁵, Papapit Tuchinda²⁵, Cascia Day⁵, Mimi Deetlefs²⁶, Felix Aulenbacher¹, Karsten Weller¹, Pavel Kolkhir¹, Martin Metz¹, Manuel Pedro Pereira²⁷

Affiliations

¹ Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Immunology and Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany.
² Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Immunology and Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany; Research Department, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon; Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus; Clinical Epidemiology Department, Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban, Beirut, Lebanon.
³ Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Milan, Italy.
⁴ Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Immunology and Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany; Department of Dermatology, Bahcesehir University, Istanbul, Turkey.
⁵ Division of Allergology and Clinical Immunology, Department of Medicine, University of Cape Town, Cape Town, South Africa; Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa.
⁶ St John's Institute of Dermatology, Guy's and St Thomas' Hospital, London, United Kingdom.
⁷ Department of Dermatology, Venerology, and Allergology, University of Essen, Essen, Germany.
⁸ Department of Dermatology, University Medical Center Mainz, Mainz, Germany.
⁹ Department of Dermatology, University Allergy Center, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.
¹⁰ Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Biomedical Sciences, Copenhagen, Denmark.
¹¹ Department of Dermatology, Hospital del Mar Research Institute, Universität Pompeu Fabra, Barcelona, Spain.
¹² Department of Internal Medicine and Clinical Immunology, Grenoble Alpes University Hospital, Grenoble Alpes University, Grenoble, France.
¹³ Allergy Unit, Second Department of Dermatology and Venereology, National and Kapodistrian University, University General Hospital Attikon, Athens, Greece.
¹⁴ National and Kapodistrian University of Athens, Medical School, First Department of Dermatology, Andreas Sygros Hospital, Athens, Greece.
¹⁵ Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
¹⁶ Allergy and Clinical Immunology, Birjand University of Medical Sciences, Birjand, Iran.
¹⁷ Department of Dermatology, Erasmus MC Rotterdam, Rotterdam, The Netherlands; Centre for Human Drug Research, Leiden, The Netherlands.
¹⁸ European Center for Diagnosis and Treatment of Urticaria, Medical University of Silesia, Silesia, Poland.
¹⁹ Immunopathology Department, NRC Institute of Immunology FMBA of Russia, Moscow, Russian Federation; Department of Immunology, Pirogov Russian National Research Medical University, Moscow, Russian Federation.
²⁰ Moscow Research and Clinical Center of Allergy and Immunology, City Clinical Hospital 52, Moscow Healthcare Department, Moscow, Russian Federation; Department of Clinical Immunology and Allergology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation; Department of Pulmonology, Astana Medical University, Astana, Kazakhstan.
²¹ Moscow Research and Clinical Center of Allergy and Immunology, City Clinical Hospital 52, Moscow Healthcare Department, Moscow, Russian Federation.
²² Department of Dermatology, Smolensk State Medical University, Smolensk, Russian Federation.
²³ University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia.
²⁴ University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
²⁵ Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
²⁶ Division of Allergology and Clinical Immunology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
²⁷ Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Immunology and Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany. Electronic address: manuel.pereira@charite.de.

PMID: 40447048
DOI: 10.1016/j.jaip.2025.05.033

Free article

Parameters Linked With Higher Itch Severity in Chronic Spontaneous Urticaria-Chronic Urticaria Registry Results

Jules Stolz et al. J Allergy Clin Immunol Pract. 2025 Sep.

Free article

. 2025 Sep;13(9):2349-2360.e3.

doi: 10.1016/j.jaip.2025.05.033. Epub 2025 May 28.

Authors

Affiliations

¹ Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Immunology and Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany.
² Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Immunology and Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany; Research Department, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon; Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus; Clinical Epidemiology Department, Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban, Beirut, Lebanon.
³ Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Milan, Italy.
⁴ Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Immunology and Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany; Department of Dermatology, Bahcesehir University, Istanbul, Turkey.
⁵ Division of Allergology and Clinical Immunology, Department of Medicine, University of Cape Town, Cape Town, South Africa; Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa.
⁶ St John's Institute of Dermatology, Guy's and St Thomas' Hospital, London, United Kingdom.
⁷ Department of Dermatology, Venerology, and Allergology, University of Essen, Essen, Germany.
⁸ Department of Dermatology, University Medical Center Mainz, Mainz, Germany.
⁹ Department of Dermatology, University Allergy Center, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.
¹⁰ Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Biomedical Sciences, Copenhagen, Denmark.
¹¹ Department of Dermatology, Hospital del Mar Research Institute, Universität Pompeu Fabra, Barcelona, Spain.
¹² Department of Internal Medicine and Clinical Immunology, Grenoble Alpes University Hospital, Grenoble Alpes University, Grenoble, France.
¹³ Allergy Unit, Second Department of Dermatology and Venereology, National and Kapodistrian University, University General Hospital Attikon, Athens, Greece.
¹⁴ National and Kapodistrian University of Athens, Medical School, First Department of Dermatology, Andreas Sygros Hospital, Athens, Greece.
¹⁵ Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
¹⁶ Allergy and Clinical Immunology, Birjand University of Medical Sciences, Birjand, Iran.
¹⁷ Department of Dermatology, Erasmus MC Rotterdam, Rotterdam, The Netherlands; Centre for Human Drug Research, Leiden, The Netherlands.
¹⁸ European Center for Diagnosis and Treatment of Urticaria, Medical University of Silesia, Silesia, Poland.
¹⁹ Immunopathology Department, NRC Institute of Immunology FMBA of Russia, Moscow, Russian Federation; Department of Immunology, Pirogov Russian National Research Medical University, Moscow, Russian Federation.
²⁰ Moscow Research and Clinical Center of Allergy and Immunology, City Clinical Hospital 52, Moscow Healthcare Department, Moscow, Russian Federation; Department of Clinical Immunology and Allergology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation; Department of Pulmonology, Astana Medical University, Astana, Kazakhstan.
²¹ Moscow Research and Clinical Center of Allergy and Immunology, City Clinical Hospital 52, Moscow Healthcare Department, Moscow, Russian Federation.
²² Department of Dermatology, Smolensk State Medical University, Smolensk, Russian Federation.
²³ University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia.
²⁴ University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
²⁵ Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
²⁶ Division of Allergology and Clinical Immunology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
²⁷ Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Immunology and Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany. Electronic address: manuel.pereira@charite.de.

PMID: 40447048
DOI: 10.1016/j.jaip.2025.05.033

Abstract

Background: Itch is the most bothersome symptom in chronic spontaneous urticaria (CSU) and severely affects quality of life.

Objective: To analyze factors associated with itch severity, and how itch is associated with quality of life and health care use in CSU.

Methods: We retrieved patient data from the Chronic Urticaria Registry. Patients were categorized by self-reported itch severity (recall period of 7 days). We used ordinal logistic regressions as well as negative binomial and gamma regressions with log link to investigate possible associations.

Results: A total of 3,045 patients, 74.3% female, mean age 44.4 years, with no, mild, moderate, or intense itch (16.4%, 25.2%, 32.5%, and 25.9%, respectively) were included. A higher itch rating was associated with symptomatic dermographism (odds ratio [OR] = 1.25; P = .027), malaise (OR = 1.43; P < .001), depression (OR = 1.46; P = .008), and laboratory signs of inflammation (ie, elevated erythrocyte sedimentation rate (OR = 1.57; P = .031) and leukocyte counts (OR = 2.37; P = .004)). Intense itch was associated with worse quality of life (Chronic Urticaria Quality of Life Questionnaire; P < .001) and more patients visiting a general practitioner, allergologist or dermatologist, and the emergency room (P < .001).

Conclusions: Higher itch levels are associated with inflammation and depression and are linked to worse quality of life and increased health care demand. Addressing itch is crucial to reducing the humanistic and societal burden in CSU.

Keywords: Chronic pruritus; Chronic spontaneous urticaria; Depression; Health-related quality of life; Inflammation; Itch.

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Parameters Linked With Higher Itch Severity in Chronic Spontaneous Urticaria-Chronic Urticaria Registry Results

Affiliations

Parameters Linked With Higher Itch Severity in Chronic Spontaneous Urticaria-Chronic Urticaria Registry Results

Authors

Affiliations

Abstract

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Research Materials