Prevalence, treatment and burden of chronic spontaneous urticaria in five European countries
Maria‐Magdalena Balp, Kathryn Krupsky, Shaloo Gupta, Clementine Lienhard, Ravneet K. Kohli, Dhaval Patil, F. Tétart, John Reed, Tariq El‐Shanawany
Abstract
BACKGROUND: Although chronic spontaneous urticaria (CSU) is a common form of chronic urticaria (CU), its impact on overall disease burden and treatment patterns in real-world settings requires further understanding. OBJECTIVES: To assess prevalence, treatment patterns, disease profile and burden in patients with CSU in five European countries (EU5: France, Germany, Italy, Spain and the United Kingdom [UK]). METHODS: Data were from the 2020 EU5 National Health and Wellness Survey (NHWS). Age- and sex-adjusted prevalence of diagnosed CSU was estimated for the overall EU5 and by country. Sociodemographic, health characteristics, treatment history and dermatology-specific quality of life were described for the CSU cohort. Patient-reported outcomes, including the Short Form 12-item Survey (SF-12v2) mental (MCS), physical component (PCS) summary scores; SF-6D; EQ-5D; General Anxiety Disorder-7 (GAD-7); Patient Health Questionnaire-9 (PHQ-9); Work Productivity and Activity Impairment (WPAI) and healthcare resource use (HRU), were summarized for the CSU cohort, overall and by country and descriptively compared to the full NHWS sample. RESULTS: Of 62,319 respondents, 794 patients were diagnosed with CU. Among these, 519 had CSU. Weighted prevalence of CSU in EU5 was 0.92%. Roughly half of the CSU cohort was treated with prescription and/or over-the-counter medication. Among the CSU cohort, 36.7% of patients experienced a very large to extremely large disease impact (Dermatology Life Quality Index [DLQI] > 10); most had poorly controlled disease (71.6%). Mean MCS, PCS, SF-6D and EQ-5D scores were worse for CSU versus the full NHWS sample. A higher proportion of the CSU cohort, versus the full NHWS sample, had GAD-7 and PHQ-9 scores of ≥5. Mild-severe anxiety, depression and WPAI scores were highest in the UK. HRU was higher in the CSU cohort than in the full NHWS sample. CONCLUSIONS: CSU negatively impacts patients' lives. Yet, many patients remain inadequately treated and uncontrolled. These results highlight a need for comprehensive care approaches to improve patient outcomes.