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

Kocatürk E. Salameh P. Asero R. Bizjak M. Gimenez-Arnau A. Grattan C. Pesqué D. Planella-Fontanillas N. Herzog L.S. Buttgereit T. Bonnekoh H. Fomina D. Kovalkova E. Lebedkina M. Kasperska-Zajac A. Zając M. Zamłyński M. Kulthanan K. Tuchinda P. Khoshkhui M. Hassanpour Z. Peter J. Du-Thanh A. Meshkova R. Abuzakouk M. Makris M. Bouillet L. Bocquet A. Gregoriou S. Thomsen S.F. Dissemond J. Staubach P. Bauer A. Danilycheva I. van Doorn M. Parisi C. Metz M. Fluhr J.W. Zuberbier T. Weller K. Kolkhir P.
January 2026 John Wiley and Sons Inc

Journal of the European Academy of Dermatology and Venereology
2026 #40 Issue 1 67 - 78 pp.

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).

age , angioedema , autoimmune disease , chronic disease , chronic spontaneous urticaria , comorbidity , depression , female , health status disparities , hormones , male , menopause , microchimerism , quality of life , sex differences , treatment outcome , urticaria

Text of the article Перейти на текст статьи

Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
Department of Dermatology, Bahçeşehir University School of Medicine, Istanbul, Turkey
Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
Institut National de Santé Publique d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon
Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy
Division of Allergy, University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia
Department of Dermatology, Hospital del Mar Research Institute, Universitat Pompeu Fabra, Barcelona, Spain
Guy’s Hospital, St John’s Institute of Dermatology, London, United Kingdom
Moscow Research and Clinical Center of Allergy and Immunology, Moscow Healthcare Department, City Clinical Hospital, Moscow, Russian Federation
Department of Clinical Immunology and Allergology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
Department of Pulmonology, Astana Medical University, Astana, Kazakhstan
European Center for Diagnosis and Treatment of Urticaria/Angioedema (GA2LEN UCARE/ACARE Network), Department of Clinical Allergology and Urticaria, Medical University of Silesia, Katowice, Poland
Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Department of Allergy and Immunology, School of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran
Division of Allergy and Clinical Immunology, University of Cape Town, Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa
Dermatology Department, University of Montpellier, Montpellier, France
Department of Clinical Immunology and Allergology, Smolensk State Medical University, Smolensk, Russian Federation
Department of Allergy & Immunology, MSI, Cleveland Clinic, Abu Dhabi, United Arab Emirates
Allergy Unit “D. Kalogeromitros”, 2nd Department Dermatology and Venereology, National and Kapodistrian University of Athens, “Attikon” University Hospital, Athens, Greece
National Reference Center for Angioedema, Grenoble University Hospital, Grenoble, France
1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athina, Greece
Department of Biomedical Sciences, Bispebjerg Hospital, Copenhagen, Denmark
Department of Dermatology, University of Copenhagen, Copenhagen, Denmark
Department of Dermatology, Venerology and Allergology, University of Essen, Essen, Germany
Department of Dermatology, University Medical Center, Mainz, Germany
Department of Dermatology, University Hospital, Carl Gustav Carus, Technical University Dresden, Dresden, Germany
Department of Allergology, NRC Institute of Immunology FMBA of Russia, Moscow, Russian Federation
Department of Dermatology, Erasmus MC, Rotterdam, Netherlands
Centre for Human Drug Research, Leiden, Netherlands
Hospital Italiano de Buenos Aires, Secciones Allergia, Buenos Aires, Argentina

Institute of Allergology
Fraunhofer Institute for Translational Medicine and Pharmacology ITMP
Department of Dermatology
Gilbert and Rose-Marie Chagoury School of Medicine
Department of Primary Care and Population Health
Faculty of Pharmacy
Institut National de Santé Publique d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB)
Ambulatorio di Allergologia
Division of Allergy
Department of Dermatology
Guy’s Hospital
Moscow Research and Clinical Center of Allergy and Immunology
Department of Clinical Immunology and Allergology
Department of Pulmonology
European Center for Diagnosis and Treatment of Urticaria/Angioedema (GA2LEN UCARE/ACARE Network)
Department of Dermatology
Allergy Research Center
Department of Allergy and Immunology
Division of Allergy and Clinical Immunology
Dermatology Department
Department of Clinical Immunology and Allergology
Department of Allergy & Immunology
Allergy Unit “D. Kalogeromitros”
National Reference Center for Angioedema
1st Department of Dermatology-Venereology
Department of Biomedical Sciences
Department of Dermatology
Department of Dermatology
Department of Dermatology
Department of Dermatology
Department of Allergology
Department of Dermatology
Centre for Human Drug Research
Hospital Italiano de Buenos Aires

10 лет помогаем публиковать статьи Международный издатель

Книга Публикация научной статьи Волощук 2026 Book Publication of a scientific article 2026