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

Thomas Buttgereit, Carolina Vera, Felix Aulenbacher, Martin K. Church, Tomasz Hawro, Riccardo Asero, Andrea Bauer, Mojca Bizjak, Laurence Bouillet, Joachim Dissemond, Daria Fomina, Ana M. Giménez-Arnau, Clive Grattan, Stamatios Gregoriou, Kanokvalai Kulthanan, Alicja Kasperska-Zajac, Emek Kocatürk, Michael Makris, Pavel Kolkhir, Karsten WellerMarkus Magerl, Marcus Maurer*

*Corresponding author for this work


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.

Original languageEnglish
JournalJournal of Allergy and Clinical Immunology: In Practice
Issue number11
Pages (from-to)3515-3525.e4
Publication statusPublished - 11.2023

DFG Research Classification Scheme

  • 205-19 Dermatology

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