E Kocatürk1, M Al-Ahmad2, K Krause3, A Gimenez-Arnau4, S F Thomsen5, N Conlon6, A Marsland7, E Savk8, R F Criado9, I Danilycheva10, D Fomina11, K Godse12, M Khoshkhui13, A Gelincik14, E N Degirmentepe15, S Demir14, L F Ensina16, A Kasperska-Zajac17, M Rudenko18, S Valle19, I Medina20, A Bauer21, Z Zhao22, P Staubach23, L Bouillet24, Ö Su Küçük25, C Ateş26, M Maurer27. 1. Urticaria Center of Reference and Excellence (UCARE), Dept. of Dermatology, Koç University School of Medicine, Istanbul, Turkey. 2. Urticaria Center of Reference and Excellence (UCARE), Microbiology Department, Faculty of Medicine, Kuwait University, Safat, Kuwait. 3. Urticaria Center of Reference and Excellence (UCARE), Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany. 4. Urticaria Center of Reference and Excellence (UCARE), Department of Dermatology, Hospital del Mar, IMIM, UniversitatAutònoma, Barcelona, Spain. 5. Urticaria Center of Reference and Excellence (UCARE), Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark. 6. Urticaria Center of Reference and Excellence (UCARE), Dermatology, and Immunology, St James's Hospital, Dublin, Ireland. 7. Urticaria Center of Reference and Excellence (UCARE), Department of Dermatology, The Urticaria Clinic, Salford Royal Foundation Trust, University of Manchester, Manchester, UK. 8. Aydın Adnan Menderes University, Aydın, Turkey. 9. Urticaria Center of Reference and Excellence (UCARE), Faculdade de Medicina do ABC (FMABC), Santo André, Brazil. 10. NRC Institute of Immunology FMBA of Russia, Moscow, Russia. 11. First Moscow State Medical University, Moscow, Russia, Urticaria Center of Reference and Excellence (UCARE), Moscow Center of Allergy and Immunology, Clinical Hospital 52, Ministry of Moscow Healthcare. 12. Dr.D.Y.Patil Medical college & Hospital, Mumbai, India. 13. Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 14. Istanbul Faculty of Medicine Istanbul University, Istanbul, Turkey. 15. Okmeydani Training and Research Hospital, Istanbul, Turkey. 16. Federal University of São Paulo, Sao Paulo, Brazil. 17. European Center for Diagnosis and Treatment of Urticaria (GA2LEN UCARE Network) Medical University of Silesia in Katowice, Poland. 18. The London Allergy & Immunology Centre, London, United Kingdom. 19. Federal University of Rio de Janeiro, Rio De Janeiro, Brazil. 20. The Centro Médico Vitae, Buenos Aires, Argentina. 21. Department of Dermatology, University Allergy Center, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany. 22. Department of Dermatology and Venerology, Peking University First Hospital, Beijing Key Laboratory of molecular Diagnosis on Dermatoses and National Clinical Research Center for Skin and Immune Diseases, Beijing, China. 23. Johannes Gutenberg-UniversitätKöR, Mainz, Germany. 24. CHU de Grenoble Alpes, Grenoble, France. 25. Bezmialem University, Istanbul, Turkey. 26. Aksaray University School of Medicine, Department of Biostatistics, Aksaray, Turkey. 27. Urticaria Center of Reference and Excellence (UCARE), Dermatological Allergology, Allergie-Centrum-Charité, Dept. of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany.
Abstract
BACKGROUND: Chronic urticaria (CU) predominantly affects women, and sex hormones can modulate disease activity in female CU patients. As of now, the impact of pregnancy on CU is largely unknown. AIM: To analyse the course and features of CUduring and after pregnancy. PATIENTS AND METHODS: PREG-CU is an international, multicentre study of the Urticaria Centers of Reference and Excellence (UCARE) network. Data were collected via a 47-item-questionnaire completed by CU patients, who became pregnant within the last 3 years. RESULTS: A total of 288 pregnancies of 288 CU patients from 13 countries were analysed (mean age at pregnancy: 32.1 ± 6.1 years, duration of CU: 84.9 ±74.5 months; CSU 66.9%, CSU+CIndU 20.3%, CIndU 12.8%).During pregnancy, 51.1% of patients rated their CU as improved, 28.9% as worse, and 20.0% as unchanged.CU exacerbations most commonly occurred exclusively during the third trimester (in 34 of 124 patients; 27.6%) or the first (28 of 124; 22.8%). The risk factors for worsening of CU during pregnancy were having mild disease and no angioedema before pregnancy, not taking treatment before pregnancy, CIndU, CU worsening during a previous pregnancy, treatment during pregnancy and stress as a driver of exacerbations. After giving birth, urticaria disease activity remained unchanged in 43.8% of CU patients, whereas 37.4% and 18.1% experienced worsening and improvement, respectively. CONCLUSIONS: These results demonstrate the complex impact of pregnancy on the course of CU and help to better counsel patients who want to become pregnant and to manage CU during pregnancy. This article is protected by copyright. All rights reserved.
BACKGROUND:Chronic urticaria (CU) predominantly affects women, and sex hormones can modulate disease activity in female CU patients. As of now, the impact of pregnancy on CU is largely unknown. AIM: To analyse the course and features of CUduring and after pregnancy. PATIENTS AND METHODS: PREG-CU is an international, multicentre study of the Urticaria Centers of Reference and Excellence (UCARE) network. Data were collected via a 47-item-questionnaire completed by CU patients, who became pregnant within the last 3 years. RESULTS: A total of 288 pregnancies of 288 CU patients from 13 countries were analysed (mean age at pregnancy: 32.1 ± 6.1 years, duration of CU: 84.9 ±74.5 months; CSU 66.9%, CSU+CIndU 20.3%, CIndU 12.8%).During pregnancy, 51.1% of patients rated their CU as improved, 28.9% as worse, and 20.0% as unchanged.CU exacerbations most commonly occurred exclusively during the third trimester (in 34 of 124 patients; 27.6%) or the first (28 of 124; 22.8%). The risk factors for worsening of CU during pregnancy were having mild disease and no angioedema before pregnancy, not taking treatment before pregnancy, CIndU, CU worsening during a previous pregnancy, treatment during pregnancy and stress as a driver of exacerbations. After giving birth, urticaria disease activity remained unchanged in 43.8% of CU patients, whereas 37.4% and 18.1% experienced worsening and improvement, respectively. CONCLUSIONS: These results demonstrate the complex impact of pregnancy on the course of CU and help to better counsel patients who want to become pregnant and to manage CU during pregnancy. This article is protected by copyright. All rights reserved.
Authors: Pavel Kolkhir; Ana M Giménez-Arnau; Kanokvalai Kulthanan; Jonny Peter; Martin Metz; Marcus Maurer Journal: Nat Rev Dis Primers Date: 2022-09-15 Impact factor: 65.038
Authors: Emek Kocatürk; Indrashis Podder; Ana C Zenclussen; Alicja Kasperska Zajac; Daniel Elieh-Ali-Komi; Martin K Church; Marcus Maurer Journal: Front Allergy Date: 2022-07-07