Abstract
BACKGROUND: Сhronic spontaneous urticaria is characterized by itchy wheals and/or angioedema on the skin for ≥6 weeks. A large-scale international AWARE study by Russian researchers indicated the ineffectiveness of therapy with standard doses of second-generation antihistamines in 50% of patients with chronic spontaneous urticaria. Clinical predictors of antihistamine resistance include low quality of life based on CU-Q2oL, baseline urticaria activity score for 7 days (UAS7) 16, combination with chronic inducible urticaria, and autoimmune comorbidity. Currently, research into the clinical predictors of antihistamine resistance, including body mass index, in patients with chronic spontaneous urticaria is ongoing.
 AIM: To examine the degree of symptom control based on body mass index and physical activity in patients with chronic spontaneous urticaria treated with second-generation antihistamines.
 MATERIALS AND METHODS: The examination of patients with сhronic spontaneous urticaria (n=34) included the clinical history and use of the following international questionnaires: UAS7, urticaria control test, dermatology quality of life index, and global physical activity questionnaire of the World Health Organization. The questionnaires were analyzed in subgroups of patients with controlled and uncontrolled chronic spontaneous urticaria and subgroups of patients with chronic spontaneous urticaria having normal weight, overweight, and obesity.
 RESULTS: Uncontrolled symptoms were observed in 24 (70.6%) patients with chronic spontaneous urticaria, including 11 (45.8%) with resistance to fourfold doses of second-generation antihistamines. In 52.9% of patients with chronic spontaneous urticaria, the body mass index exceeded normal values. In this study, an inverse correlation was found between the body mass index and the degree of control of chronic spontaneous urticaria symptoms.
 CONCLUSIONS: Owing to the negative correlation between body mass index and the degree of symptom control, further research into the role of body mass index as a clinical predictor of antihistamine-resistant chronic spontaneous urticaria is needed. In the future, personalized therapy for chronic spontaneous urticaria may consider the degree of disease control, clinical predictors of antihistamine resistance, and proinflammatory biomarkers.
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