TY - JOUR
T1 - Non–Skin Related Symptoms Are Common in Chronic Spontaneous Urticaria and Linked to Active and Uncontrolled Disease
T2 - Results From the Chronic Urticaria Registry
AU - Pyatilova, Polina
AU - Hackler, Yana
AU - Aulenbacher, Felix
AU - Asero, Riccardo
AU - Bauer, Andrea
AU - Bizjak, Mojca
AU - Day, Cascia
AU - Dissemond, Joachim
AU - Du-Thanh, Aurélie
AU - Fomina, Daria
AU - Giménez-Arnau, Ana M.
AU - Grattan, Clive
AU - Gregoriou, Stamatis
AU - Hawro, Tomasz
AU - Kasperska-Zajac, Alicja
AU - Khoshkhui, Maryam
AU - Kocatürk, Emek
AU - Kovalkova, Elena
AU - Kulthanan, Kanokvalai
AU - Kuznetsova, Elizaveta
AU - Makris, Michael
AU - Mukhina, Olga
AU - Pesqué, David
AU - Peter, Jonny
AU - Salameh, Pascale
AU - Siebenhaar, Frank
AU - Sikora, Agnieszka
AU - Staubach, Petra
AU - Tuchinda, Papapit
AU - Zamłyński, Mateusz
AU - Weller, Karsten
AU - Maurer, Marcus
AU - Kolkhir, Pavel
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024
Y1 - 2024
N2 - 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.
AB - 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.
KW - and muscle pain
KW - bone
KW - Chronic spontaneous urticaria
KW - Fever
KW - Joint
KW - Malaise
KW - Non–skin related symptoms
UR - http://www.scopus.com/inward/record.url?scp=85194371086&partnerID=8YFLogxK
U2 - 10.1016/j.jaip.2024.04.027
DO - 10.1016/j.jaip.2024.04.027
M3 - Article
C2 - 38670260
AN - SCOPUS:85194371086
SN - 2213-2198
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
ER -