Sex matters in CSU : Women face greater burden and poorer urticaria control, especially in midlife— CURE insights
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Chronic spontaneous urticaria (CSU), a disease predominantly affecting females, has limited information available on its differences between females and males of varying ages. OBJECTIVES: To investigate sex differences in age groups regarding disease activity, comorbidities, quality of life (QoL) and treatment patterns in CSU patients. METHODS: We analysed Chronic Urticaria Registry (CURE) data, an international real-world registry for patients with chronic urticaria. Patients were recruited via an online platform using a standardized questionnaire. The data were analysed for demographics, age of onset, duration of urticaria, (Urticaria Activity Score [UAS], Urticaria Control Test [UCT], Chronic Urticaria Quality of Life Questionnaire [CU-Q2oL]), family history, systemic symptoms, aggravating factors, comorbidities, smoking and alcohol consumption, laboratory parameters, burden of disease, treatment distribution and response rates, compliance to treatment and adverse events. Comparisons were made among age groups <13, 13-17, 18-30, 31-50, 51-65 and >65 years. RESULTS: Across 4136 CSU patients (from 58 sites across 29 countries), 2994 (72.4%) were female. Statistically significant female predominance started at age 31 (<0.001). Compared with males, females showed higher rates of angioedema (59.6 vs. 51.7%; p < 0.001), systemic symptoms (34.6 vs. 25.4%; p < 0.001), sleep disturbance (38.9 vs. 32.5%; p < 0.001), QoL impairment (CU-Q2oL score 32 vs. 27.7; p < 0.001) and lower rates of urticaria control than males in all medication categories (p < 0.05 for all). Females had more concomitant diseases, including asthma, thyroid disease, obesity, autoimmune disease, gastrointestinal disease and depression (p < 0.05 for all). The disease was especially more burdensome and refractory in females aged 51-65 years than males, evidenced by more angioedema and systemic symptoms, worse QoL, lower UCT scores and more emergency visits (p < 0.05 for all). However, these differences were not prominent in the elderly females (>65 years). CONCLUSIONS: Compared with males, female CSU patients experience more burdensome disease, which gets worse in midlife. CLINICALTRIALS: gov (or equivalent) listing (if applicable None).
DOI: 10.1111/jdv.70027
Authors: Emek Kocatürk, Pascale Salameh, Riccardo Asero, Mojca Bizjak, Ana Gimenez‐Arnau, Clive Grattan, David Pesqué, Nidia Planella‐Fontanillas, Leonie Shirin Herzog, Thomas Buttgereit, Hanna Bonnekoh, Daria Fomina, Elena Kovalkova, Marina Lebedkina, Alicja Kasperska‐Zajac, Magdalena Zając, Mateusz Zamłyński, Kanokvalai Kulthanan, Papapit Tuchinda, Maryam Khoshkhui, Zohreh Hassanpour, Jonny Peter, Aurelie Du‐Thanh, Raisa Meshkova, Mohamed Abuzakouk, Michael Makris, Laurence Bouillet, Alexis Bocquet, Stamatios Gregoriou, Simon Francis Thomsen, Joachim Dissemond, Petra Staubach, Andrea Bauer, Inna Danilycheva, Martijn van Doorn, Claudio Parisi, Martin Metz, Joachim W. Fluhr, Torsten Zuberbier, Karsten Weller, Pavel Kolkhir
Institutions: Bahçeşehir University, Humboldt-Universität zu Berlin, Fraunhofer Institute for Translational Medicine and Pharmacology, Freie Universität Berlin, Charité - Universitätsmedizin Berlin, Lebanese University, University of Nicosia, Lebanese American University, University Clinic of Pulmonary and Allergic Diseases Golnik, Universitat Pompeu Fabra, Hospital del Mar Research Institute, Guy's Hospital, Sechenov University, City Clinical Hospital, Astana Medical University, Medical University of Silesia, Siriraj Hospital, Mahidol University, Mashhad University of Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, University of Cape Town, Université de Montpellier, Smolensk State Medical University, Cleveland Clinic Abu Dhabi, National and Kapodistrian University of Athens, University General Hospital Attikon, Centre Hospitalier Universitaire de Grenoble, Andreas Sygros Hospital, University of Copenhagen, Bispebjerg Hospital, Essen University Hospital, University of Duisburg-Essen, University Medical Center of the Johannes Gutenberg University Mainz, University Hospital Carl Gustav Carus, Technische Universität Dresden, Federal Medical-Biological Agency, Erasmus MC, Centre for Human Drug Research, Hospital Italiano de Buenos Aires
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $5,450
OpenAlex ID: W4414330192