Peptic Ulcer Disease is Associated with Increased Risk of Chronic Urticaria Independent of Helicobacter pylori Infection
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ORIGINAL RESEARCH ARTICLE
Peptic Ulcer Disease is Associated with Increased Risk of Chronic Urticaria Independent of Helicobacter pylori Infection: A Population‑Based Cohort Study Chun‑Ming Chen1,2 · Wan‑Ting Huang3 · Li‑Jen Chang4 · Chih‑Cheng Hsu5,6 · Yueh‑Han Hsu7,8,9
© Springer Nature Switzerland AG 2020
Abstract Background Some studies showed patients with chronic urticaria have a higher rate of peptic ulcer disease (PUD). Whether PUD is a risk factor for chronic urticaria is unclear. Objective The objective of this study was to evaluate the incidence of and risk factors for chronic urticaria in patients with PUD using the Taiwan National Health Insurance Research Database. Methods We conducted a retrospective nationwide cohort study of the period 2000–2012 and involving 11,901 patients with PUD who underwent Helicobacter pylori (HP) therapy (PUD + HP group) and an equal number of matched patients without HP infection (PUD − HP group). Furthermore, we enrolled 23,802 patients without PUD for comparison (nonPUD group). The Cox proportional hazards regression model was used to analyze chronic urticaria risk after adjusting for potential confounding factors. Results The mean ages of the three groups were around 50 years. Approximately 42.6% were female. Chronic urticaria incidences in the PUD + HP and PUD − HP groups were both significantly higher than that in the non-PUD group. The hazard ratios of chronic urticaria in the PUD + HP group and the PUD − HP group were 1.34 (95% confidence interval 1.09–1.64) and 1.45 (95% confidence interval 1.19–1.79), respectively. The risk difference became significant 2 years after patients with PUD had the HP infection tests and persisted till the end of follow-up. The risk increase was significant in patients with PUD who were female or aged 40–64 years. There was no difference in the risk comparison between PUD + HP and PUD − HP groups. Conclusions Peptic ulcer disease, independent of HP infection, is associated with an increased chronic urticaria risk. Patients with PUD who were female or aged 40–64 years are more likely to have chronic urticaria. Key Points Peptic ulcer disease was associated with an increased risk of chronic urticaria independent of Helicobacter pylori infection. The risk difference became significant 2 years after patients with peptic ulcer disease had the H. pylori infection tests and persisted till the end of follow-up. The risk increase was significant in patients with peptic ulcer disease who were female or aged 40–64 years. Peptic ulcer disease may be considered in patients with chronic urticaria and gastrointestinal discomfort. * Yueh‑Han Hsu [email protected] Extended author information available on the last page of the article
1 Introduction Chronic urticaria (CU), a mast-cell-driven and histaminemediated disease, is characterized by wheals (hives), angioedema, or both for more than 6 weeks [1]. The estimated point prevalence of CU worldwide is approximately 0.5–1% [2]. In Taiwan, CU prevalence is approximately 0.69–0.79% [3]. In app
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