The burden of symptomatic patients with chronic spontaneous urticaria: a real-world study in Korea
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Background/Aims: Chronic spontaneous urticaria (CSU) poses a considerable burden both on the quality of life (QoL) of individual patients and on healthcare systems. Real‑world data evaluating the disease burden of CSU are limited in this country. This study evaluated the disease burden and healthcare resource utilization (HRU) among symptomatic CSU patients. Methods: This multicenter, noninterventional, retrospective, and cross-sectional study assessed CSU patients symptomatic for more than 6 months despite step-wise H1-antihistamine medications. Primary outcomes included Urticaria Activity Score over 7 days (UAS7) and Chronic Urticaria QoL scale (CU-QoL). Secondary outcomes included EuroQol 5-Dimension 5-Level (EQ-5D-5L), Dermatology Life Quality Index (DLQI), association of disease activity with QoL, medications used for the past 6 months, and HRU. Results: Five hundred patients with CSU were enrolled. Mean disease duration was 3.7 years. Based on UAS7, 22.2% of patients were in well-controlled status and 31.2%, 28.4%, and 18.2% of them had mild, moderate, and severe disease, respectively. Mean CU-QoL and DLQI scores were 57.5 ± 29.7 and 10.2 ± 7.6, respectively, while the EQ-5D-5L utility score was 0.8 ± 0.2. H1-antihistamines were prescribed to 95% of patients, while omalizumab was prescribed to 33% of patients. Most patients (98%) had outpatient visits in the past 6 months. Negative correlations were noted between UAS7 and CUQoL, EQ-5D-5L, EQ-5D-5L visual analog scale scores, but a positive correlation was noted with DLQI score (p < 0.001 for all). The number of outpatient department visits increased with disease activity (p = 0.001). Conclusions: CSU affects QoL, leading to increased HRU, particularly in patients with severe disease.
Abstract
Background/Aims: Chronic spontaneous urticaria (CSU) poses a considerable burden both on the quality of life (QoL) of individual patients and on healthcare systems. Real‑world data evaluating the disease burden of CSU are limited in this country. This study evaluated the disease burden and healthcare resource utilization (HRU) among symptomatic CSU patients. Methods: This multicenter, noninterventional, retrospective, and cross-sectional study assessed CSU patients symptomatic for more than 6 months despite step-wise H1-antihistamine medications. Primary outcomes included Urticaria Activity Score over 7 days (UAS7) and Chronic Urticaria QoL scale (CU-QoL). Secondary outcomes included EuroQol 5-Dimension 5-Level (EQ-5D-5L), Dermatology Life Quality Index (DLQI), association of disease activity with QoL, medications used for the past 6 months, and HRU. Results: Five hundred patients with CSU were enrolled. Mean disease duration was 3.7 years. Based on UAS7, 22.2% of patients were in well-controlled status and 31.2%, 28.4%, and 18.2% of them had mild, moderate, and severe disease, respectively. Mean CU-QoL and DLQI scores were 57.5 ± 29.7 and 10.2 ± 7.6, respectively, while the EQ-5D-5L utility score was 0.8 ± 0.2. H1-antihistamines were prescribed to 95% of patients, while omalizumab was prescribed to 33% of patients. Most patients (98%) had outpatient visits in the past 6 months. Negative correlations were noted between UAS7 and CUQoL, EQ-5D-5L, EQ-5D-5L visual analog scale scores, but a positive correlation was noted with DLQI score (p < 0.001 for all). The number of outpatient department visits increased with disease activity (p = 0.001). Conclusions: CSU affects QoL, leading to increased HRU, particularly in patients with severe disease.
참고문헌 (34)
- Zuberbier T, "The international EAACI", GA²LEN, APAAACI guideline for the definition, classification, diagnosis, and management of urticaria, pp.Allergy, 2022[DOI]
- 송우정, "The KAAACI", KDA Evidence-Based Practice Guidelines for Chronic Spontaneous Urticaria in Korean Adults and Children: Part 1. Definition, Methodology and First-line Management, 2020, pp.12(4), 563~578[DOI]
- Maurer M, "Unmet clinical needs in chronic spontaneous urticaria. A GA²LEN task force report", Allergy, 66, pp.317~330 (2011)
- Antia C, "Urticaria : a comprehensive review : epidemiology, diagnosis, and work-up", J Am Acad Dermatol, 79, pp.599~614 (2018)
- Zuberbier T, "Epidemiology of urticaria : a representative cross-sectional population survey", Clin Exp Dermatol, 35, pp.869~873 (2010)
- Chu CY, "Epidemiology and comorbidities of patients with chronic urticaria in Taiwan : a nationwide population-based study", J Dermatol Sci, 88, pp.192~198 (2017)
- Stepaniuk P, "Natural history, prognostic factors and patient perceived response to treatment in chronic spontaneous urticaria", Allergy Asthma Clin Immunol, 16, pp.63~ (2020)
- Staevska M, "The effectiveness of levocetirizine and desloratadine in up to 4 times conventional doses in difficult-to-treat urticaria", J Allergy Clin Immunol, 125, pp.676~682 (2010)
- Allen P. Kaplan, "Treatment of Chronic Spontaneous Urticaria", Allergy, Asthma & Immunology Research, 4(6), pp.326~331 (2012), 대한천식알레르기학회
- Curto-Barredo L, "Treatment of chronic spontaneous urticaria with an inadequate response to H1-antihistamine", G Ital Dermatol Venereol, 154, pp.444~456 (2019)
- 최정희, "The KAAACI", KDA Evidence-Based Practice Guidelines for Chronic Spontaneous Urticaria in Korean Adults and Children: Part 2. Management of H1-Antihistamine-Refractory Chronic Urticaria, 2020, pp.12(5), 750~770[DOI]
- Barbosa F, "Chronic idiopathic urticaria and anxiety symptoms", J Health Psychol, 16, pp.1038~1047 (2011)
- Gil-Soon Choi, "Anxiety, depression, and stress in Korean patients with chronic urticaria", The Korean Journal of Internal Medicine, 35(6), pp.1507~1516 (2020), 대한내과학회[DOI]
- Maurer M, "The burden of chronic spontaneous urticaria is substantial : real-world evidence from ASSURE-CSU", Allergy, 72, pp.2005~2016 (2017)
- Maurer M, "H1-antihistamine-refractory chronic spontaneous urticaria : it’s worse than we thought : first results of the multicenter real-life AWARE study", Clin Exp Allergy, 47, pp.684~692 (2017)
- Zuberbier T, "The EAACI", GA²LEN, WAO guideline for the definition, classification, diagnosis and management of urticaria, pp.Allergy, 2018[DOI]
- Hawro T, "The urticaria activity score : validity, reliability, and responsiveness", J Allergy Clin Immunol Pract, 6, pp.1185~1190 (2018)
- Ye YM, "Clinical evaluation of the computerized chronic urticaria-specific quality of life questionnaire in Korean patients with chronic urticaria", Clin Exp Dermatol, 37, pp.722~728 (2012)
- Kim SH, "The EQ-5D-5L valuation study in Korea", Qual Life Res, 25, pp.1845~1852 (2016)
- Finlay AY, "Dermatology Life Quality Index(DLQI) : a simple practical measure for routine clinical use", Clin Exp Dermatol, 19, pp.210~216 (1994)
- "Medical statistics information" (2022)[URL]
- "Medical service fee information" (2022)[URL]
- "Translation rate information" (2022)[URL]
- Stull D, "Analysis of disease activity categories in chronic spontaneous", idiopathic urticaria, 2017, pp.177, 1093~1101
- Khalil S, "Weekly urticaria activity score(UAS7)and dermatology life quality index(DLQI)in validation of chronic spontaneous", idiopathic urticaria(CSU, J Allergy Clin Immunol, pp.2015, 135[DOI]
- Fricke J, "Prevalence of chronic urticaria in children and adults across the globe : systematic review with meta-analysis", Allergy, 75, pp.423~432 (2020)
- Sussman G, "Angioedema in chronic spontaneous urticaria is underdiagnosed and has a substantial impact : analyses from ASSURE-CSU", Allergy, 73, pp.1724~1734 (2018)
- Kocaturk E, "Management of chronic inducible urticaria according to the guidelines : a prospective controlled study", J Dermatol Sci, 87, pp.60~69 (2017)
- Kolkhir P, "Management of urticarial vasculitis : a worldwide physician perspective", World Allergy Organ J, 13, pp.100107~ (2020)
- Maurer M, "Antihistamine-resistant chronic spontaneous urticaria : 1-year data from the AWARE study", Clin Exp Allergy, 49, pp.655~662 (2019)
- Won-Sun Choi, "Disease-specific impairment of the quality of life in adult patients with chronic spontaneous urticaria", The Korean Journal of Internal Medicine, 33(1), pp.185~192 (2018), 대한내과학회[DOI]
- Min-Sang Lee, "Health-Related Utility of EQ-5D in Korean Adults With Chronic Urticaria: Mapping From Urticaria Outcome Measures", Allergy, Asthma & Immunology Research, 12(4), pp.599~607 (2020), 대한천식알레르기학회
- Alen Coutinho I, "Refractory chronic urticaria in adults : clinical characterization and predictors of severity", Allergy Asthma Clin Immunol, 16, pp.97~ (2020)
- Lacour JP, "The burden of chronic spontaneous urticaria : unsatisfactory treatment and healthcare resource utilization in France(the ASSURE-CSU study)", Eur J Dermatol, 28, pp.795~802 (2018)
