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

  • Jules Stolz
  • , Pascale Salameh
  • , Riccardo Asero
  • , Emek Kocatürk
  • , Jonny Peter
  • , Clive Grattan
  • , Leonie Shirin Herzog
  • , Melba Muñoz
  • , Joachim Dissemond
  • , Petra Staubach-Renz
  • , Andrea Bauer
  • , Simon Francis Thomsen
  • , Ana M. Giménez-Arnau
  • , Maria Puertolas
  • , Alexis Bocquet
  • , Michael Makris
  • , Stamatios Gregoriou
  • , Maryam Khoshkhui
  • , Samaneh Kouzegaran
  • , Martijn Bastiaan Adriaan van Doorn
  • Alicja Kasperska-Zajac, Maciej Gąsior, Magdalena Zając, Elena Latysheva, Daria Fomina, Elena Kovalkova, Gerelma Andrenova, Elizaveta Sedova, Alexandr Vitchuk, Mojca Bizjak, Mitja Košnik, Kanokvalai Kulthanan, Papapit Tuchinda, Cascia Day, Mimi Deetlefs, Felix Aulenbacher, Karsten Weller, Pavel Kolkhir, Martin Metz, Manuel Pedro Pereira

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)2349-2360.e3
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume13
Issue number9
DOIs
Publication statusPublished - Sept 2025
Externally publishedYes

Keywords

  • Chronic pruritus
  • Chronic spontaneous urticaria
  • Depression
  • Health-related quality of life
  • Inflammation
  • Itch

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