Non-Skin Related Symptoms Are Common in Chronic Spontaneous Urticaria and Linked to Active and Uncontrolled Disease: Results From the Chronic Urticaria Registry.
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Pyatilova Polina, Hackler Yana, Aulenbacher Felix, Asero Riccardo, Bauer Andrea, Bizjak Mojca, Day Cascia, Dissemond Joachim, Du-Thanh Aurélie, Fomina Daria, Giménez-Arnau Ana M, Grattan Clive, Gregoriou Stamatis, Hawro Tomasz, Kasperska-Zajac Alicja, Khoshkhui Maryam, Kocatürk Emek, Kovalkova Elena, Kulthanan Kanokvalai, Kuznetsova Elizaveta, Makris Michael, Mukhina Olga, Pesqué David, Peter Jonny, Salameh Pascale, Siebenhaar Frank, Sikora Agnieszka, Staubach Petra, Tuchinda Papapit, Zamłyński Mateusz, Weller Karsten, Maurer Marcus, Kolkhir Pavel
Аннотация
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.