Systemic manifestations during symptomatic episodes in chronic spontaneous urticaria: Results from the Urticaria Voices study

• Published in: Revue française d'allergologie (2009) 2024-04, Vol.64, p.103857, Article 103857
• Main Authors: Coste, M., Bernstein, J.A., Winders, T.A., Raftery, T., Saraswat, P., Mccarthy, J., Kuruvilla, M., Balp, M.M., Weller, K.
• Format: Article
• Language: English
• ISSN: 1877-0320; 1877-0320
• DOI: 10.1016/j.reval.2024.103857

Chronic spontaneous urticaria (CSU) is characterised by recurrent wheals (hives) and/or angioedema for>6-weeks. Some patients may have extracutaneous systemic symptoms during episodes of wheals and/or angioedema. Here, we describe the prevalence and characteristics of systemic symptoms among CSU patients during worsening episodes as reported in the Urticaria Voices study. Urticaria Voices, a multinational cross-sectional study, assessed the overall burden and management of CSU in adult patients undergoing physician-prescribed treatments. Patients completed an online survey comprising of questions on cutaneous and extracutaneous systemic symptoms, disease-severity (as reported by their physician) and treatments. Data were analyzed using descriptive statistics. Overall, 582 CSU patients (women, 62%; age, mean [SD], 42.2 [11.9] years; 79% currently on H1-antihistamines; 43% with angioedema in past 12-months) participated in the study. In the previous 4 weeks, 47% of patients reported a physician assessment during which disease activity was reported as mild (16%), moderate (49%), severe (18%), very severe (11%) and not known/no symptoms (6%). In addition to the core CSU symptoms (itch, hives, angioedema), difficulty in sleeping (62%), pain (55%) and fatigue (49%) were the most frequent patient-reported physical symptoms during CSU-worsening. Most patients reported pain at the location of hives (58%), angioedema (33%), and joints (36%) during episodes of disease worsening. Less frequent symptoms included flushing, headache, and gastrointestinal symptoms. This study shows that patients experience extracutaneous symptoms beyond itch, hives and/or angioedema during CSU worsening, which suggests a high physical impact. New therapies that offer sustained relief from CSU exacerbations are needed.