A RECENT international study, presented at the European Academy of Allergy and Clinical Immunology Congress 2025, has shed new light on the complex nature of chronic spontaneous urticaria (CSU), a condition marked by the recurring appearance of hives without an obvious external cause.
The RIFA-CU study aimed to explore the prevalence of various medical and lifestyle factors among patients with CSU compared to healthy individuals, identifying potential modifiable risk factors that could help improve patient outcomes.
Conducted across 19 countries, this large-scale observational study gathered data from 1,392 patients with CSU and 1,374 healthy controls using a standardised questionnaire. Participants were asked about their health status and experiences in the months leading up to the onset of urticaria symptoms. The results revealed significant differences between the two groups, highlighting a broader and more complex clinical picture in patients with CSU.
Systemic diseases were found to be notably more common in those with CSU. Conditions such as diabetes mellitus, thyroid disease, stomach disorders, and high cholesterol levels were all significantly more prevalent in the patient group. Autoimmune diseases and osteoporosis also showed increased rates in CSU sufferers, suggesting a broader pattern of immune system involvement.
Infectious diseases such as urinary tract infections, dental infections, and parasitic infections occurred more frequently in patients with CSU. However, there was no significant difference between groups in the prevalence of Helicobacter pylori or recurrent herpes infections.
Psychiatric comorbidities were also more common in patients with CSU, with elevated rates of anxiety and panic attacks reported. Furthermore, allergic conditions such as food allergies, contact dermatitis, allergic asthma, and drug hypersensitivities were significantly more prevalent. In contrast, rates of atopic dermatitis and allergic rhinitis did not differ notably between groups.
Overall, the findings from the RIFA-CU study highlights the need for a comprehensive, multidisciplinary approach to CSU care. Addressing both dermatological symptoms and associated systemic, psychiatric, and allergic conditions may be key to improving quality of life and long-term outcomes for patients.
Reference
Can P et al. Comorbidities including infections and atopic conditions in CSU patients compared to healthy controls: results from the first, large, multinational case control study -RIFA-CU. Abstract 001190. EAACI Congress, 13-16 June, 2025.
