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Patients With Chronic Idiopathic Urticaria at Higher Risk of Developing Food Allergies
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Key Takeaways
- CIU patients have a 1 in 4 risk of developing food allergies, similar across adult and pediatric populations.
- A history of atopy or food allergies increases the risk of developing urticaria.
Knowing which patients are at higher risk for developing urticaria by analyzing their history of food allergies could lead to better outcomes in this population.
According to the results of a systematic review and meta-analysis, patients with chronic idiopathic urticaria (CIU) had a higher risk of developing food allergies, with the risk observed in 1 in 4 patients and a similar risk among adult and pediatric populations. The investigators also found that patients with a history of atopy or food allergies are at a higher risk of urticaria.1
Chronic idiopathic urticaria can be a major burden for both adults and children. Food allergy history could help shed light on the potential for CIU development. | Image Credit: © wisely | stock.adobe.com
The data, published in the journal Archives of Dermatological Research, indicates a common factor among CIU patients and can allow pharmacists and treatment providers to better identify patients at higher risk. Furthermore, treatment providers can use this information to alter management strategies as necessary to minimize possible complications and sustain disease control.1
Because of the chronic and unpredictable nature of this condition, patients and health care providers managing CIU can be faced with significant burdens. Oftentimes, diagnosis requires detailed analysis of patient history and a comprehensive examination. Determining other allergic conditions potentially associated with CIU is critical to developing new methods of diagnosis and better assessing patient risk.2
Prior authors have attempted to find a relationship between CIU—with or without angioedema—and food allergies. In this analysis, the current investigators sought to analyze currently available trials that have assessed the relationship between food allergies and CIU to determine the prevalence of food allergy in diagnosed patients with CIU.1
Ultimately, the review included 1551 patients with urticaria, with a total of 105 patients with atopic diseases and 268 with food allergies. Seven investigations examined the risk of food allergy among patients with urticaria; the patients with food allergies had a 24.9% risk of urticaria (13.6%-41.1%, p = .004) in the investigators’ random-effects model.1
Age-based risk was also assessed in patients with urticaria. In 5 articles, the risk of food allergy was assessed in adults, with a collective risk of 25.4% (11.2%-47.9%, p = ,034). For children, 2 articles assessed food allergy risk, for which their pooled risk was determined to be 24.1% (9.7%-48.3%, p = .037), according to the study authors.1
The risk of angioedema with urticaria among patients with food allergy was also examined. In 3 articles, 1023 patients with urticaria were included and their risk of angioedema was reported. Random-effects model results showed a 26.9% risk of angioedema associated with urticaria (12.5%-48.7%, p = .039). In addition, a meta-analysis of patients with urticaria and a positive family history of atopy revealed a 37.9% prevalence of a family history of atopy in those patients (24.3%-53.8%, p = 0.133), according to the investigators.1
Studies have previously identified various allergens associated with CIU, but the risk of food allergies in patients with urticaria had to this point not been thoroughly investigated. These results emphasize the critical nature of a detailed evaluation and provided history of food allergies so treatment providers can provide fully optimized treatment tailored to a patient’s need, in addition to potentially detecting CIU early.1,3
Some limitations of this trial were noted. The included articles in the meta-analysis had observational designs, which reveal possible risks of information bias and selection reporting. There was also significant statistical heterogeneity found among the analyzed studies, which could be due to multiple factors, including the study design, follow-up period, or the presence of food allergens.1
“This knowledge is important for identifying patients at a higher risk of chronic idiopathic urticaria and implementing the necessary management strategies to minimize potential complications and maintain controlled disease,” the study authors concluded.1
REFERENCES
1. Alotaibi HM, Alghamdi AS, Almutairi RT, et al. The prevalence of food allergy in patients with chronic idiopathic urticaria: a systematic review and meta-analysis. Archives Derm Research. 2024;317(132). doi:10.1007/s00403-024-03613-w
2. Fonacier L, Aquino M, Kim B, et al. Clinical evaluation and treatment of chronic urticaria. Postgraduate Medicine. 2010;122(2):148-156. doi:10.3810/pgm.2010.03.2132
3. Kolkhir P, Giménez-Arnau AM, Kulthanan K, et al. Urticaria. Nat Rev Dis Primers. 2022;8(61). doi:10.1038/s41572-022-00389-z
