Journal of the European Academy of Dermatology and Venereology

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Chronic spontaneous urticaria (CSU), a disease predominantly affecting females, has limited information available on its differences between females and males of varying ages.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To investigate sex differences in age groups regarding disease activity, comorbidities, quality of life (QoL) and treatment patterns in CSU patients.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>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 &lt;13, 13–17, 18–30, 31–50, 51–65 and &gt;65 years.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Across 4136 CSU patients (from 58 sites across 29 countries), 2994 (72.4%) were female. Statistically significant female predominance started at age 31 (&lt;0.001). Compared with males, females showed higher rates of angioedema (59.6 vs. 51.7%; <jats:italic>p</jats:italic> &lt; 0.001), systemic symptoms (34.6 vs. 25.4%; <jats:italic>p</jats:italic> &lt; 0.001), sleep disturbance (38.9 vs. 32.5%; <jats:italic>p</jats:italic> &lt; 0.001), QoL impairment (CU‐Q2oL score 32 vs. 27.7; <jats:italic>p</jats:italic> &lt; 0.001) and lower rates of urticaria control than males in all medication categories (<jats:italic>p</jats:italic> &lt; 0.05 for all). Females had more concomitant diseases, including asthma, thyroid disease, obesity, autoimmune disease, gastrointestinal disease and depression (<jats:italic>p</jats:italic> &lt; 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 (<jats:italic>p</jats:italic> &lt; 0.05 for all). However, these differences were not prominent in the elderly females (&gt;65 years).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Compared with males, female CSU patients experience more burdensome disease, which gets worse in midlife.</jats:p><jats:p><jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="http://clinicaltrials.gov">Clinicaltrials.gov</jats:ext-link> (or equivalent) listing (if applicable None).</jats:p></jats:sec>

publication_history

received

accepted

published

Sanofi

Moxie Foundation

Novartis

Chronic spontaneous urticaria: a review

JAMA

The international EAACI/GA2 LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria

Allergy

The global burden of chronic urticaria for the patient and society

Br J Dermatol

Chronic spontaneous urticaria: new evidences on the role of autoimmunity

Curr Opin Allergy Clin Immunol

Prevalence of chronic urticaria in children and adults across the globe: systematic review with meta‐analysis

The challenges of chronic urticaria part 1: epidemiology, immunopathogenesis, comorbidities, quality of life, and management

World Allergy Organ J

Urticaria

Nat Rev Dis Primers

Epidemiology of urticaria including physical urticaria and angioedema in Korea

Korean J Intern Med

Factors linked to disease severity and time to remission in patients with chronic spontaneous urticaria

J Eur Acad Dermatol Venereol

Burden of and trends in urticaria globally, regionally, and nationally from 1990 to 2019: systematic analysis

JMIR Public Health Surveill

Turkish version of the chronic urticaria quality of life questionnaire: cultural adaptation, assessment of reliability and validity

Acta Derm Venereol

Sleep quality as a predictor of quality‐of‐life and emotional status impairment in patients with chronic spontaneous urticaria: a cross‐sectional study

Int J Environ Res Public Health

Fatigue is common and predicted by female gender and sleep disturbance in patients with chronic spontaneous urticaria

J Allergy Clin Immunol Pract

The burden on cohabitants of patients with chronic spontaneous urticaria: a cross‐sectional study

J Clin Med

A systematic review and meta‐analysis of health utility estimates in chronic spontaneous urticaria

Front Med (Lausanne)

The German version of the chronic urticaria quality‐of‐life questionnaire: factor analysis, validation, and initial clinical findings

Why autoimmune disease is more common in women: X chromosome holds clues

Nature

Sex differences in the pathogenesis of chronic urticaria

J Allergy Clin Immunol

The chronic urticaria registry: rationale, methods and initial implementation

Patients with chronic spontaneous urticaria who have wheals, angioedema, or both, differ demographically, clinically, and in response to treatment‐results from CURE

The benefit of complete response to treatment in patients with chronic spontaneous urticaria‐CURE results

Natural course of new‐onset urticaria: results of a 10‐year follow‐up, nationwide, population‐based study

Allergol Int

Gender differences in autoimmune disease

Front Neuroendocrinol

Urticaria in pregnancy and lactation

Front Allergy

Effects of pregnancy on chronic urticaria: results of the PREG‐CU UCARE study

Effect of puberty, menstruation, pregnancy, lactation, and menopause on chronic urticaria activity

J Cutan Med Surg

Non‐skin related symptoms are common in chronic spontaneous urticaria and linked to active and uncontrolled disease: results from the chronic urticaria registry

The relationship between sleep quality and chronotype differences and urticaria severity in patients with chronic spontaneous urticaria

Acta Dermatovenerol Alp Pannonica Adriat

The burden of chronic spontaneous urticaria is substantial: real‐world evidence from ASSURE‐CSU

The urticaria control test and urticaria activity score correlate with quality of life in adult Japanese patients with chronic spontaneous urticaria

Most patients with autoimmune chronic spontaneous urticaria also have autoallergic urticaria, but not ViceVersa

The relation of autologous serum and plasma skin test results with urticarial activity score, sex and age in patients with chronic urticaria

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Chronic urticaria sera increase basophil CD203c expression

Autoimmune comorbidity in chronic spontaneous urticaria: a systematic review

Autoimmun Rev

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Curr Allergy Asthma Rep

Gender differences at the onset of autoimmune thyroid diseases in children and adolescents

Front Endocrinol (Lausanne)

Why women have more autoimmune diseases than men: an evolutionary perspective

Evol Appl

Sex‐ and gender‐related differences in common functional Gastroenterologic disorders

Mayo Clin Proc

Why is depression more prevalent in women?

J Psychiatry Neurosci

Depression scores change significantly after omalizumab treatment in patients with chronic spontaneous urticaria

Asian Pac J Allergy Immunol

C‐reactive protein is linked to disease activity, impact, and response to treatment in patients with chronic spontaneous urticaria

Biomarkers of chronic spontaneous urticaria and their clinical implications

Expert Rev Clin Immunol

Predictors of treatment response in chronic spontaneous urticaria

Omalizumab for the treatment of chronic spontaneous urticaria: association between body mass index and outcome

Dermatol Pract Concept

Effects of a pseudoallergen‐free diet on chronic spontaneous urticaria: a prospective trial

Do women ‘over‐report’ morbidity? Men's and women's responses to structured prompting on a standard question on long standing illness

Soc Sci Med

Chronic spontaneous urticaria (CSU), a disease predominantly affecting females, has limited information available on its differences between females and males of varying ages.
To investigate sex differences in age groups regarding disease activity, comorbidities, quality of life (QoL) and treatment patterns in CSU patients.
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.
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).
Compared with males, female CSU patients experience more burdensome disease, which gets worse in midlife.
gov (or equivalent) listing (if applicable None).

Sex matters in CSU: Women face greater burden and poorer urticaria control, especially in midlife-CURE insights.

Sex matters in <scp>CSU</scp>: Women face greater burden and poorer urticaria control, especially in midlife—<scp>CURE</scp> insights

Sex matters in <scp>CSU</scp>: Women face greater burden and poorer urticaria control, especially in midlife—<scp>CURE</scp> insights

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