Ep. 122: Mortality in adult patients with chronic spontaneous urticaria - A real-world cohort study
Part of the series: The Itch Review
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Do adults with chronic spontaneous urticaria (CSU) have a higher risk of death over time compared to people without hives?
We review the findings from “Mortality in adult patients with chronic spontaneous urticaria: A real-world cohort study,” published in April 2025, in The Journal of Allergy and Clinical Immunology. While CSU is often considered a non-life-threatening condition, this large study found something surprising: people with CSU had a significantly higher risk of death, especially from suicide.
Our hosts walk through key takeaways from a dataset of over 272,000 CSU patients and nearly 13 million matched controls. They explore what the results mean for mortality risk, clinical care, mental health screening, and the importance of proper, guideline-based treatment.
What we cover in our episode about CSU and death risk:
What is CSU? Chronic hives is an unpredictable, itchy, and sometimes painful condition. It lasts for 6 weeks or longer and can continue for years.
Mental health connection: CSU affects more than skin. Anxiety, depression, and suicidal thoughts are common and serious concerns.
Study findings: CSU was associated with higher mortality at 3 months, 1 year, and 5 years. Suicide risk was over 3 times higher than in people without CSU.
Demographics: Younger and White patients with CSU had the highest increase in risk.
Treatment impact: Patients using guideline-recommended treatments like second-generation antihistamines or omalizumab had lower death rates.
The Itch Review - Avapritinib versus Placebo Infographic
More resources about hives
Chronic Idiopathic Urticaria – also known as chronic spontaneous urticaria
More episodes about urticaria
The Itch Review, hosted by Dr. Gupta, Kortney, and Dr. Blaiss, explores allergy and immunology studies, breaking down complex research in conversations accessible to clinicians, patients, and caregivers. Each episode provides key insights from journal articles and includes a one-page infographic in the show notes for easy reference.
Timestamps
Our episode reviews death rates in adult patients with chronic spontaneous urticaria
01:49 Overview of chronic spontaneous urticaria (CSU)
03:40 Purpose and goals of the study
04:54 Study methods and data sources
06:57 Explanation of propensity score matching
09:03 Patient inclusion criteria
11:05 What the researchers measured and analyzed
12:28 Summary of key results
13:19 Finding #1: CSU is associated with increased mortality
17:29 Mortality rates by age and race
20:42 Comorbidities linked to higher death rates, including suicide
23:00 Type of treatment and its impact on mortality
27:56 Dr. Gupta’s takeaways
