Unmet Needs in Treatment Escalation for Chronic Spontaneous Urticaria: Findings From the CURE Registry
Issued Date
2026-01-01
Resource Type
ISSN
01054538
eISSN
13989995
Scopus ID
2-s2.0-105027513884
Pubmed ID
41532642
Journal Title
Allergy European Journal of Allergy and Clinical Immunology
Rights Holder(s)
SCOPUS
Bibliographic Citation
Allergy European Journal of Allergy and Clinical Immunology (2026)
Suggested Citation
Kolkhir P., Salameh P., Zajac M., Kasperska-Zajac A., Giménez-Arnau A., Puertolas M., Bonnekoh H., Vera Ayala C., Makris M., Chatzidimitriou E., Gregoriou S., Kulthanan K., Bauer A., Bizjak-Suran M., Fomina D., Bocquet A., Dissemond J., Abuzakouk M., Raftery T., Chapman-Rothe N., Kocatürk E., Grattan C., Asero R., Peter J.G., Thomsen S.F., Weller K. Unmet Needs in Treatment Escalation for Chronic Spontaneous Urticaria: Findings From the CURE Registry. Allergy European Journal of Allergy and Clinical Immunology (2026). doi:10.1111/all.70199 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/114658
Title
Unmet Needs in Treatment Escalation for Chronic Spontaneous Urticaria: Findings From the CURE Registry
Author(s)
Kolkhir P.
Salameh P.
Zajac M.
Kasperska-Zajac A.
Giménez-Arnau A.
Puertolas M.
Bonnekoh H.
Vera Ayala C.
Makris M.
Chatzidimitriou E.
Gregoriou S.
Kulthanan K.
Bauer A.
Bizjak-Suran M.
Fomina D.
Bocquet A.
Dissemond J.
Abuzakouk M.
Raftery T.
Chapman-Rothe N.
Kocatürk E.
Grattan C.
Asero R.
Peter J.G.
Thomsen S.F.
Weller K.
Salameh P.
Zajac M.
Kasperska-Zajac A.
Giménez-Arnau A.
Puertolas M.
Bonnekoh H.
Vera Ayala C.
Makris M.
Chatzidimitriou E.
Gregoriou S.
Kulthanan K.
Bauer A.
Bizjak-Suran M.
Fomina D.
Bocquet A.
Dissemond J.
Abuzakouk M.
Raftery T.
Chapman-Rothe N.
Kocatürk E.
Grattan C.
Asero R.
Peter J.G.
Thomsen S.F.
Weller K.
Author's Affiliation
Københavns Universitet
Charité – Universitätsmedizin Berlin
National and Kapodistrian University of Athens
Universität Duisburg-Essen
Sechenov First Moscow State Medical University
Universitat Pompeu Fabra Barcelona
Novartis International AG
Slaski Uniwersytet Medyczny w Katowicach
Univerza v Mariboru
Guy's Hospital
Universitätsklinikum Carl Gustav Carus Dresden
Centre Hospitalier Universitaire de Grenoble
Siriraj Hospital
Bispebjerg Hospital
Université Libanaise
Groote Schuur Hospital
Bahçeşehir Üniversitesi
Univerza v Ljubljani Medicinska Fakulteta
Moscow Healthcare Department
Cleveland Clinic Abu Dhabi
University of Nicosia Medical School
Astana Medical University
Fraunhofer Institute for Translational Medicine and Pharmacology ITMP
Gilbert and Rose-Marie Chagoury School of Medicine
Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban
University of Cape Town Lung Institute
Bolnišnica Golnik
Novartis Ireland Limited
Clinica San Carlo
Charité – Universitätsmedizin Berlin
National and Kapodistrian University of Athens
Universität Duisburg-Essen
Sechenov First Moscow State Medical University
Universitat Pompeu Fabra Barcelona
Novartis International AG
Slaski Uniwersytet Medyczny w Katowicach
Univerza v Mariboru
Guy's Hospital
Universitätsklinikum Carl Gustav Carus Dresden
Centre Hospitalier Universitaire de Grenoble
Siriraj Hospital
Bispebjerg Hospital
Université Libanaise
Groote Schuur Hospital
Bahçeşehir Üniversitesi
Univerza v Ljubljani Medicinska Fakulteta
Moscow Healthcare Department
Cleveland Clinic Abu Dhabi
University of Nicosia Medical School
Astana Medical University
Fraunhofer Institute for Translational Medicine and Pharmacology ITMP
Gilbert and Rose-Marie Chagoury School of Medicine
Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban
University of Cape Town Lung Institute
Bolnišnica Golnik
Novartis Ireland Limited
Clinica San Carlo
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Many patients with chronic spontaneous urticaria (CSU) remain symptomatic despite receiving second-generation H<inf>1</inf>-antihistamines (sgH<inf>1</inf>-AH). This data analysis from the Chronic Urticaria Registry (CURE) aimed to describe treatment patterns and identify unmet needs in real-world practice. Methods: CURE is an international, prospective registry of patients with chronic urticaria. Treatment responses were categorized as Urticaria Control Test (UCT) changes from baseline (BL) to 6-month follow-up (FU). Complete response was defined as UCT = 16 with a ≥ 3-point increase. Results: Data were available from 3995 adult patients with CSU at BL and 1288 at FU with evaluable UCT. After treatment escalation from BL to FU, 5.3% (no treatment to licensed-dose sgH<inf>1</inf>-AH), 6.0% (licensed-dose sgH<inf>1</inf>-AH to up-dosed sgH<inf>1</inf>-AH), and 28.4% (any dose sgH<inf>1</inf>-AH to omalizumab) achieved complete response. Factors associated with a lower probability of treatment escalation at FU were UCT ≥ 12 and omalizumab treatment at BL (both p < 0.0001). About one-third (28.6%) of patients clinically eligible for escalation at BL (UCT < 12) did not receive step-up treatment (18.0%) or were even stepped down (10.6%) and remained poorly controlled at FU. Factors associated with lack of escalation in this group included younger age (p = 0.014), shorter disease duration (p = 0.071), presence of wheals and angioedema (p = 0.002), better quality of life (p = 0.001), and treatment with up-dosed sgH<inf>1</inf>-AH (p = 0.031). Conclusion: Appropriate treatment escalation improves CSU control, although only about a quarter of patients achieve a complete response, indicating the need for novel treatments. Many patients with poorly controlled CSU do not receive guideline-recommended treatment escalation and remain symptomatic on their current treatments, which deserves further attention.