Evaluation of antihistamine-refractory chronic urticaria patients who used biological agent treatment in terms of cardiovascular risk

Introduction:
The idea that chronic inflammatory processes may play a role in the etiopathogenesis of both treatment – refractory chronic spontaneous urticaria and cardiovascular diseases is an important research topic.

Aim:
Within the scope of this research, we aimed to elucidate a new perspective on the follow-up of chronic urticaria patients by evaluating the 10-year cardiovascular risk and metabolic syndrome in resistant chronic spontaneous urticaria patients who were unresponsive to maximum antihistamine treatment.

Material and methods:
A total of 170 individuals who applied to our institution’s Health Science University, Tepecik Education and Research Hospital, allergy and immunology outpatient clinic have been analysed in this retrospective case-control study. Metabolic syndrome was calculated according to the National Cholesterol Education Program –- Adult Treatment Panel III, and the cardiovascular risk was calculated according to the Framingham Heart Study of the National Heart, Lung and Blood Institute.

Results:
The study included 85 patients diagnosed with chronic spontaneous urticaria (CSU) alongside 85 control subjects. Comparative analysis between the CSU patient group and the control group revealed substantial differences in terms of gender distribution, smoking habits, metabolic syndrome prevalence, waist circumference measurements, body mass index (BMI), hypertension incidence, and levels of C-reactive protein (CRP) (p < 0.05). However, factors such as patient age, fasting blood glucose, diabetes status, triglyceride (TAG), high density lipoprotein (HDL), low density lipoprotein (LDL), and the percentage risk of cardiovascular events over 10 years were not found to influence CSU (p > 0.05).

Conclusions:
Regarding the outcomes of this study, the presence of hypertension, obesity, waist circumference and C-reactive protein values associated with metabolic syndrome should be followed for antihistamine-refractory CSU. Early diagnosis and treatment of metabolic syndrome and its components in these patients may play a role in preventing potential complications. No significant increase in the 10-year cardiovascular risk was observed.