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.

Dr. G and Dr. Blaiss 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 is CSU? Chronic hives are 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.

INFOGRAPHIC

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.

Made in partnership with The Allergy & Asthma Network.

Thanks to Novartis for sponsoring today’s episode.

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.