Non–Skin Related Symptoms Are Common in Chronic Spontaneous Urticaria and Linked to Active and Uncontrolled Disease: Results From the Chronic Urticaria Registry
Issued Date
2024-01-01
Resource Type
ISSN
22132198
Scopus ID
2-s2.0-85194371086
Pubmed ID
38670260
Journal Title
Journal of Allergy and Clinical Immunology: In Practice
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Allergy and Clinical Immunology: In Practice (2024)
Suggested Citation
Pyatilova P., Hackler Y., Aulenbacher F., Asero R., Bauer A., Bizjak M., Day C., Dissemond J., Du-Thanh A., Fomina D., Giménez-Arnau A.M., Grattan C., Gregoriou S., Hawro T., Kasperska-Zajac A., Khoshkhui M., Kocatürk E., Kovalkova E., Kulthanan K., Kuznetsova E., Makris M., Mukhina O., Pesqué D., Peter J., Salameh P., Siebenhaar F., Sikora A., Staubach P., Tuchinda P., Zamłyński M., Weller K., Maurer M., Kolkhir P. Non–Skin Related Symptoms Are Common in Chronic Spontaneous Urticaria and Linked to Active and Uncontrolled Disease: Results From the Chronic Urticaria Registry. Journal of Allergy and Clinical Immunology: In Practice (2024). doi:10.1016/j.jaip.2024.04.027 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/98603
Title
Non–Skin Related Symptoms Are Common in Chronic Spontaneous Urticaria and Linked to Active and Uncontrolled Disease: Results From the Chronic Urticaria Registry
Author(s)
Pyatilova P.
Hackler Y.
Aulenbacher F.
Asero R.
Bauer A.
Bizjak M.
Day C.
Dissemond J.
Du-Thanh A.
Fomina D.
Giménez-Arnau A.M.
Grattan C.
Gregoriou S.
Hawro T.
Kasperska-Zajac A.
Khoshkhui M.
Kocatürk E.
Kovalkova E.
Kulthanan K.
Kuznetsova E.
Makris M.
Mukhina O.
Pesqué D.
Peter J.
Salameh P.
Siebenhaar F.
Sikora A.
Staubach P.
Tuchinda P.
Zamłyński M.
Weller K.
Maurer M.
Kolkhir P.
Hackler Y.
Aulenbacher F.
Asero R.
Bauer A.
Bizjak M.
Day C.
Dissemond J.
Du-Thanh A.
Fomina D.
Giménez-Arnau A.M.
Grattan C.
Gregoriou S.
Hawro T.
Kasperska-Zajac A.
Khoshkhui M.
Kocatürk E.
Kovalkova E.
Kulthanan K.
Kuznetsova E.
Makris M.
Mukhina O.
Pesqué D.
Peter J.
Salameh P.
Siebenhaar F.
Sikora A.
Staubach P.
Tuchinda P.
Zamłyński M.
Weller K.
Maurer M.
Kolkhir P.
Author's Affiliation
Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban
Universitätsklinikum Carl Gustav Carus Dresden
Siriraj Hospital
Gilbert and Rose-Marie Chagoury School of Medicine
University of Nicosia Medical School
Berliner Institut für Gesundheitsforschung
Moscow Healthcare Department
Astana Medical University
University of Cape Town Lung Institute
Bolnišnica Golnik
Université Libanaise
Universitat Pompeu Fabra Barcelona
Centre Hospitalier Universitaire de Montpellier
Johannes Gutenberg-Universität Mainz
National and Kapodistrian University of Athens
Slaski Uniwersytet Medyczny w Katowicach
Universitat Autònoma de Barcelona
Universitätsklinikum Schleswig-Holstein Campus Lübeck
Universität Duisburg-Essen
Sechenov First Moscow State Medical University
Guy's Hospital
Koç Üniversitesi
Mashhad University of Medical Sciences
University of Cape Town
Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP)
Clinica San Carlo
Universitätsklinikum Carl Gustav Carus Dresden
Siriraj Hospital
Gilbert and Rose-Marie Chagoury School of Medicine
University of Nicosia Medical School
Berliner Institut für Gesundheitsforschung
Moscow Healthcare Department
Astana Medical University
University of Cape Town Lung Institute
Bolnišnica Golnik
Université Libanaise
Universitat Pompeu Fabra Barcelona
Centre Hospitalier Universitaire de Montpellier
Johannes Gutenberg-Universität Mainz
National and Kapodistrian University of Athens
Slaski Uniwersytet Medyczny w Katowicach
Universitat Autònoma de Barcelona
Universitätsklinikum Schleswig-Holstein Campus Lübeck
Universität Duisburg-Essen
Sechenov First Moscow State Medical University
Guy's Hospital
Koç Üniversitesi
Mashhad University of Medical Sciences
University of Cape Town
Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP)
Clinica San Carlo
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Chronic spontaneous urticaria (CSU) can present with non–skin related symptoms (NSRS), including recurrent unexplained fever, joint, bone, or muscle pain (JBMP), and malaise, which also occur in other conditions that manifest with wheals (eg, urticarial vasculitis or autoinflammatory disorders) or without wheals (eg, infection). Objective: We sought to determine the rate of patients with CSU affected by fever, JBMP, and malaise, their trigger factors, links with clinical and laboratory characteristics, and their impact on everyday life and treatment responses. Methods: We analyzed baseline data from the Chronic Urticaria Registry of 2,521 patients with CSU who were aged 16 years or older. Results: One third of CSU patients (31.2%; 786 of 2,521) had one or more NSRS, including recurrent fever (5.3%), JBMP (19.1%), and/or malaise (18.6%). In a multivariable analysis, having one or more of these NSRS correlated with food and infection as trigger factors of urticaria (adjusted odds ratio [aOR] = 1.7 and 1.5), wheals of 24 hours or greater duration (aOR = 2.5), sleep disturbance (aOR = 2.4), anxiety (aOR = 2.8), comorbid atopic dermatitis (aOR = 2.1), gastrointestinal disease (aOR = 1.8), elevated leukocytes (aOR = 1.7) and erythrocyte sedimentation rate (aOR = 1.5). In a bivariate analysis, these NSRS were additionally associated with higher disease activity (weekly Urticaria Activity Score, median: 21 vs 14; P = .009), longer disease duration (years, median: 2 vs 1; P = .001), the presence of angioedema (74.6% vs 58.7%; P < .001), worse quality of life (Chronic Urticaria Quality of Life Questionnaire, median: 42 vs 29; P < .001) and more frequent poor control of CSU (78% vs 69%; P < .001). Conclusions: The presence of NSRS in a subpopulation of patients with CSU points to the need for better control of the disease, exclusion of comorbid conditions, and/or exclusion of urticarial vasculitis and urticarial autoinflammatory diseases.