Disease-specific impairment of the quality of life in adult patients with chronic spontaneous urticaria
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Background/Aims: Chronic urticaria (CU) is a common skin disorder characterized by wheals and pruritus lasting more than 6 weeks. Due to its long duration and changeable symptoms, the quality of life (QOL) of patients with CU can be impaired substantially. We evaluated the CU-QOL, a previously validated CU-specific QOL measure, and investigated factors influencing QOL in chronic spontaneous urticaria (CSU) patients. Methods: A hospital-based cross-sectional study was performed on 390 adult patients diagnosed with CSU from March 2009 to December 2012 at the Allergy and Clinical Immunology Clinic at Ajou University Hospital. The CU-QOL questionnaire, urticaria activity score (UAS), combined angioedema, and serum total immunoglobulin E (IgE) levels were investigated. Results: The average CU-QOL score obtained from the questionnaire was 70.6 (of 100 points). The CU-QOL scores correlated significantly with the UAS, particularly with the 15-point UAS (UAS-15; coefficient –0.532, p < 0.01) rather than the 6-point UAS (–0.502, p < 0.01). The patients presenting with angioedema and urticaria had poorer scores in the urticaria symptom domain than those with urticaria alone (37.4 vs. 46.9, p = 0.004). Log-transformed serum total IgE levels correlated significantly with CU-QOL (–0.131, p < 0.05). Multivariate regression models indicated that severe CU (UAS-15 score ≥ 13), log (total IgE), and the presence of angioedema were significant predictors of impaired CU-QOL (< 85 points). Conclusions: CU has a substantial negative impact on QOL. The assessment of UAS-15, total IgE, and the presence of angioedema can be useful to predict QOL of the patients with CSU.
Abstract
Background/Aims: Chronic urticaria (CU) is a common skin disorder characterized by wheals and pruritus lasting more than 6 weeks. Due to its long duration and changeable symptoms, the quality of life (QOL) of patients with CU can be impaired substantially. We evaluated the CU-QOL, a previously validated CU-specific QOL measure, and investigated factors influencing QOL in chronic spontaneous urticaria (CSU) patients. Methods: A hospital-based cross-sectional study was performed on 390 adult patients diagnosed with CSU from March 2009 to December 2012 at the Allergy and Clinical Immunology Clinic at Ajou University Hospital. The CU-QOL questionnaire, urticaria activity score (UAS), combined angioedema, and serum total immunoglobulin E (IgE) levels were investigated. Results: The average CU-QOL score obtained from the questionnaire was 70.6 (of 100 points). The CU-QOL scores correlated significantly with the UAS, particularly with the 15-point UAS (UAS-15; coefficient –0.532, p < 0.01) rather than the 6-point UAS (–0.502, p < 0.01). The patients presenting with angioedema and urticaria had poorer scores in the urticaria symptom domain than those with urticaria alone (37.4 vs. 46.9, p = 0.004). Log-transformed serum total IgE levels correlated significantly with CU-QOL (–0.131, p < 0.05). Multivariate regression models indicated that severe CU (UAS-15 score ≥ 13), log (total IgE), and the presence of angioedema were significant predictors of impaired CU-QOL (< 85 points). Conclusions: CU has a substantial negative impact on QOL. The assessment of UAS-15, total IgE, and the presence of angioedema can be useful to predict QOL of the patients with CSU.
참고문헌 (25)
- 예영민, "만성 두드러기의 진단과 치료: 전문가 의견서", Allergy Asthma & Respiratory Disease, 3(1), pp.3~14 (2015), 대한 소아알레르기 호흡기학회
- Zuberbier T, "The EAACI", GA(2) LEN, WAO guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update, pp.Allergy, 2014[DOI]
- Saini SS, "Chronic spontaneous urticaria: etiology and pathogenesis", Immunol Allergy Clin North Am, 34, pp.33~52 (2014)[DOI]
- O'Donnell BF, "The impact of chronic urticaria on the quality of life", Br J Dermatol, 136, pp.197~201 (1997)[DOI]
- Engin B, "The levels of depression, anxiety and quality of life in patients with chronic idiopathic urticaria", J Eur Acad Dermatol Venereol, 22, pp.36~40 (2008)
- Hashiro M, "Anxiety, depression and psychosomatic symptoms in patients with atopic dermatitis: comparison with normal controls and among groups of different degrees of severity", J Dermatol Sci, 14, pp.63~67 (1997)[DOI]
- Maurer M, "Unmet clinical needs in chronic spontaneous urticaria: a GA(2)LEN task force report", Allergy, 66, pp.317~330 (2011)[DOI]
- Ozkan M, "Psychiatric morbidity and quality of life in patients with chronic idiopathic urticaria", Ann Allergy Asthma Immunol, 99, pp.29~33 (2007)[DOI]
- Baiardini I, "A new tool to evaluate the impact of chronic urticaria on quality of life: chronic urticaria quality of life questionnaire (CU-QoL)", Allergy, 60, pp.1073~1078 (2005)[DOI]
- 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)[DOI]
- Ye YM, "Co-existence of chronic urticaria and metabolic syndrome: clinical implications", Acta Derm Venereol, 93, pp.156~160 (2013)[DOI]
- Weller K, "Development and validation of the urticaria control test: a patient-reported outcome instrument for assessing urticaria control", J Allergy Clin Immunol, 133, pp.1365~1372 (2014)[DOI]
- Baiardini I, "Recommendations for assessing patient-reported outcomes and health-related quality of life in clinical trials on allergy: a GA(2)LEN taskforce position paper", Allergy, 65, pp.290~295 (2010)[DOI]
- Zuberbier T, "Epidemiology of urticaria: a representative cross-sectional population survey", Clin Exp Dermatol, 35, pp.869~873 (2010)[DOI]
- Toubi E, "Clinical and laboratory parameters in predicting chronic urticaria duration: a prospective study of 139 patients", Allergy, 59, pp.869~873 (2004)[DOI]
- Poon E, "The extent and nature of disability in different urticarial conditions", Br J Dermatol, 140, pp.667~671 (1999)[DOI]
- Weller K, "Development and construct validation of the angioedema quality of life questionnaire", Allergy, 67, pp.1289~1298 (2012)[DOI]
- Weller K, "Development, validation, and initial results of the angioedema activity score", Allergy, 68, pp.1185~1192 (2013)
- Maurer M, "Omalizumab for the treatment of chronic idiopathic or spontaneous urticaria", N Engl J Med, 368, pp.924~935 (2013)[DOI]
- Allen P. Kaplan, "Treatment of Chronic Spontaneous Urticaria", Allergy, Asthma & Immunology Research, 4(6), pp.326~331 (2012), 대한천식알레르기학회
- 남영희, "Effects of Omalizumab Treatment in Patients With Refractory Chronic Urticaria", Allergy, Asthma & Immunology Research, 4(6), pp.357~361 (2012), 대한천식알레르기학회
- Kessel A, "Elevated serum total IgE: a potential marker for severe chronic urticaria", Int Arch Allergy Immunol, 153, pp.288~293 (2010)[DOI]
- Chang TW, "The potential pharmacologic mechanisms of omalizumab in patients with chronic spontaneous urticaria", J Allergy Clin Immunol, 135, pp.337~342 (2015)[DOI]
- Mlynek A, "How to assess disease activity in patients with chronic urticaria?", Allergy, 63, pp.777~780 (2008)[DOI]
- O'Donnell BF, "Urticaria: impact on quality of life and economic cost", Immunol Allergy Clin North Am, 34, pp.89~104 (2014)[DOI]