CLINICAL PREDICTORS OF ANTIHISTAMINE RESISTANCE IN THE PATIENTS WITH CHRONIC SPONTANEOUS URTICARIA

BACKGROUND: Сhronic spontaneous urticaria is a disease characterized by itchy wheals and/or angioedema on the skin over a period of 6 weeks or longer. A large-scale international AWARE study, with the participation of researchers from Russia, indicates the ineffectiveness of therapy with standard doses of second-generation antihistamines in more than 50% of patients with CSU. Clinical predictors for antihistamine resistance include low quality of life based on CU-Q2oL, baseline UAS7 16, combination with chronic inducible urticaria, and autoimmune comorbidity. Currently, research into clinical predictors of antihistamine resistance, including body mass index (BMI), in CSU patients is ongoing. AIMS: to examine the degree of symptoms control depending on BMI and the level of physical activity in CSU patients treated with second-generation antihistamines. MATERIALS AND METHODS: The examination of CSU patients (n=34) included the clinical history and the use of international questionnaires: UAS7 (urticaria activity score for 7 days), UCT (Urticaria Control Test), DLQI (The Dermatology life Quality Index) and GPAQ (Questionnaire on Physical Activity of the World Health organizations, WHO). The questionnaires were analyzed in subgroups of patients with controlled and uncontrolled CSU, as well as in subgroups of CSU patients with normal weight, overweight, and obesity. RESULTS: Uncontrolled symptoms were observed in 70.6% (24) CSU patients, including 45.8% (11) with a resistance to 4-fold doses of second-generation antihistamines. In 52.9% of CSU patients the BMI exceeded normal values. In our study, thre was an inverse correlation between BMI and the degree of control of CSU symptoms. CONCLUSIONS: Due to the negative correlation between BMI and the degree of symptoms control, there is a need for further research into the role of BMI as a clinical predictor of antihistamine-resistant CSU. In the future, the personalized therapy for CSU may take into account the degree of disease control, clinical predictors of antihistamine resistance and proinflammatory biomarkers.