Fuente: PubMed "hive" Ann Allergy Asthma Immunol. 2025 Nov 28:S1081-1206(25)01367-5. doi: 10.1016/j.anai.2025.11.028. Online ahead of print.ABSTRACTBACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) are major exacerbating factors in approximately one-third of chronic spontaneous urticaria (CSU) patients, contributing to disease chronicity and severity. However, comprehensive comparisons of clinical characteristics and treatment responses remain limited.OBJECTIVE: This study aimed to analyze baseline characteristics, immunologic parameters, and treatment outcomes in patients with NSAID-exacerbated chronic urticaria (NECD) compared to those with NSAID-tolerant chronic urticaria (NTCU), utilizing long-term outcome models in a large, real-world clinical cohort.METHODS: From a cohort of 9,632 adult CSU patients, 966 NECD patients were identified by diagnostic codes and were analyzed against the remaining NTCU patients. Clinical and laboratory findings, medication requirements, and long-term clinical outcomes were compared between the two groups.RESULTS: The disease duration was significantly longer in patients with NECD (42.7 ± 46.3 vs. 21.9 ± 30.9 months, P < 0.001), and the prevalence of angioedema was higher (58.1% vs. 23.4%, P < 0.001). They required longer treatment durations with antihistamines and leukotriene receptor antagonists (P < 0.001 for all). The daily dose of systemic corticosteroids was also higher (11.7 ± 6.1 vs. 10.4 ± 6.9 mg, P < 0.001). NECD patients also had longer omalizumab treatment durations, with no difference in cyclosporine use.CONCLUSION: Our findings confirm that NECD represents a more chronic and treatment-resistant phenotype within CSU patients. These results provide valuable insights into the distinct clinical and immunologic profiles of NECD, underscoring its higher disease burden and refractory nature.PMID:41319940 | DOI:10.1016/j.anai.2025.11.028