Genentech, Inc., South San Francisco, California 94080-4990, USA.
Ann Allergy Asthma Immunol. 2012 Feb;108(2):98-102. doi: 10.1016/j.anai.2011.10.018. Epub 2011 Dec 3.
The literature on chronic idiopathic urticaria (CIU) lacks large-scale population-based studies.
To characterize an insured population with CIU, including their demographic characteristics and comorbidities.
We conducted a cross-sectional analysis using insurance claims. We included patients with 1 outpatient claim with an International Classification of Diseases, 9(th)Edition, Clinical Modification (ICD-9-CM) code for idiopathic, other specified, or unspecified urticaria (ICD-9-CM 708.1, 708.8, or 708.9) and either (1) another of these claims 6 or more weeks later; (2) a claim for angioedema (ICD-9-CM 995.1) 6 or more weeks from the urticaria diagnosis; or (3) overlapping claims for 2 prescription medications commonly used for CIU.
We identified 6,019 patients who had claims consistent with CIU. The mean age was 36 years. Fifty-six percent of patients had primary care physicians as their usual source of care, 14% had allergists, and 5% had dermatologists. Allergic rhinitis was diagnosed in 48%, asthma in 21%, other allergy in 19%, and atopic dermatitis in 8%. Sixty-seven percent of patients used prescription antihistamines, 54% used oral corticosteroids (OCSs), 24% used montelukast, and 9% used oral doxepin. Antihistamine users received a mean of 152 days of prescription antihistamines, OCS users 30 days of OCSs, montelukast users 190 days of montelukast, and oral doxepin users 94 days of doxepin.
Primary care physicians managed most patients with CIU. Antihistamines were the most common treatment for CIU, although OCSs were frequently prescribed. Thirty days of OCS supply among users may represent multiple steroid bursts each year. Given the known risks of OCSs, identifying other CIU treatments with more favorable safety profiles may be beneficial.
慢性特发性荨麻疹（CIU）相关文献缺乏大规模的基于人群的研究。
描述 CIU 参保人群的特征，包括其人口统计学特征和合并症。
我们使用保险理赔数据进行了横断面分析。我们纳入了 1 份门诊索赔，该索赔具有国际疾病分类，第 9 版，临床修正版（ICD-9-CM）编码为特发性、其他特指或未特指荨麻疹（ICD-9-CM 708.1、708.8 或 708.9），并且（1）随后 6 周或更长时间内有另一项此类索赔；（2）荨麻疹诊断后 6 周或更长时间内有血管性水肿（ICD-9-CM 995.1）的索赔；或（3）重叠的 2 种常用于 CIU 的处方药物的索赔。
我们确定了 6019 名符合 CIU 诊断的患者。平均年龄为 36 岁。56%的患者以初级保健医生为其常规医疗服务提供者，14%的患者有过敏症专家，5%的患者有皮肤科医生。诊断出过敏性鼻炎占 48%，哮喘占 21%，其他过敏占 19%，特应性皮炎占 8%。67%的患者使用处方抗组胺药，54%使用口服皮质类固醇（OCS），24%使用孟鲁司特，9%使用口服多塞平。抗组胺药使用者平均接受 152 天的处方抗组胺药治疗，OCS 使用者接受 30 天的 OCS 治疗，孟鲁司特使用者接受 190 天的孟鲁司特治疗，口服多塞平使用者接受 94 天的多塞平治疗。
初级保健医生管理了大多数 CIU 患者。抗组胺药是 CIU 的最常见治疗方法，尽管经常开具 OCS。OCS 使用者每年可能有多次类固醇爆发，30 天 OCS 供应量。鉴于 OCS 的已知风险，确定其他具有更有利安全性特征的 CIU 治疗方法可能是有益的。
