In this episode of All Things Angioedema, Thomas Buttgereit speaks with Dr. Vesna Trajkova, dermatologist and researcher from Skopje, North Macedonia, about the clinical relevance of angioedema in chronic spontaneous urticaria (CSU) and what its presence reveals about disease severity and underlying mechanisms.
They discuss:
🔹 How common is angioedema in patients with CSU?
🔹 Is angioedema linked to more severe or longer-lasting disease?
🔹 What is the role of autoimmunity and autologous serum skin testing?
🔹 How should these findings influence everyday clinical practice?
Dr. Trajkova presents data from her recent study showing that 70% of CSU patients experience angioedema, with the vast majority occurring in those with severe disease. The discussion highlights associations between angioedema, higher disease activity, longer disease duration, and autoimmune markers, emphasizing that angioedema should nobe viewed as a minor accompanying symptom. Together, they explore how recognizing angioedema as a clinically meaningful marker can improve risk stratification, monitoring, and treatment decisions in CSU.
Key Learnings from the Episode:
Angioedema is highly prevalent in CSU, affecting around 70% of patients the CSU population investigated in the study.
The presence of angioedema is strongly associated with severe CSU, occurring in over 80% of severe cases.
CSU patients with angioedema tend to have a longer disease duration, indicating a higher cumulative burden.
Autoimmune markers and comorbid autoimmune diseases are more frequent in CSU patients with angioedema.
Autologous serum skin test positivity shows a trend toward higher angioedema prevalence, supporting an autoimmune component.
Angioedema does not merely coexist with CSU but acts as a marker of disease severity and complexity.
Routine CSU assessment should actively include angioedema evaluation, not just wheals and itch.
Recognizing angioedema can help guide earlier treatment escalation and closer follow-up in clinical practice.
Chapters:
00:00 Introduction to Angioedema and CSU
02:30 Guest Introduction: Vesna Trejkova
04:50 Research Rationale and Study Overview
10:34 Key Findings on Angioedema in CSU
13:15 Study Limitations and Future Directions
15:32 Clinical Implications of Research Findings
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