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从巴西患者角度看慢性荨麻疹的负担

The Burden of Chronic Urticaria from Brazilian Patients' Perspective.

作者信息

Balp Maria-Magdalena, Lopes da Silva Nilcéia, Vietri Jeffrey, Tian Haijun, Ensina Luis F

机构信息

Novartis Pharma AG, Basel, Switzerland.

Novartis Biociências S.A., São Paulo, Brazil.

出版信息

Dermatol Ther (Heidelb). 2017 Dec;7(4):535-545. doi: 10.1007/s13555-017-0191-4. Epub 2017 Jul 26.

Abstract

INTRODUCTION

Chronic urticaria (CU), a proxy for chronic spontaneous urticaria, has been associated with a negative impact on health-related quality of life (HRQoL) and costs, but there is limited evidence on the burden of CU in Brazil. The objective of this study was to estimate the prevalence of CU and assess the burden of CU on HRQoL and healthcare resource utilization (HRU) among adults in Brazil.

METHODS

This retrospective, cross-sectional study, pooled data from the 2011, 2012, and 2015 National Health and Wellness Survey in Brazil (n = 36,000). Respondents (aged ≥18 years) diagnosed with and treated for CU provided data on demographics, health history, HRQoL (mental and physical health status) on Short-Form SF-36v2, presence of psychological complaints, work impairment, activity impairment, and HRU. Generalized linear models, controlling for covariates, examined differences between those treated for CU and matched controls on the outcome variables.

RESULTS

The prevalence of diagnosed CU was 0.41% (n = 249) and treated CU was 0.21% (n = 127). After adjustments, CU (currently treated for CU) was associated with worse mental functioning, physical functioning, and health utilities compared with controls (all p < 0.01). CU had over twice the odds of anxiety and sleep difficulties, over 1.5 times the work and activity impairment, twice the number of total physician visits, eight times the number of allergist visits, and twice the number of emergency room visits as controls (all p < 0.01).

CONCLUSIONS

Many CU patients using prescription treatment experienced anxiety and sleep disturbances, poorer HRQoL, significant work and activity impairment, and high HRU, compared with matched general population controls. Findings suggest an unmet need for more effective treatment and management of CU in Brazil.

FUNDING

Novartis Pharma AG and Genentech.

摘要

引言

慢性荨麻疹(CU)作为慢性自发性荨麻疹的代表,已被证明会对健康相关生活质量(HRQoL)和成本产生负面影响,但巴西关于CU负担的证据有限。本研究的目的是估计巴西成年人中CU的患病率,并评估CU对HRQoL和医疗资源利用(HRU)的负担。

方法

这项回顾性横断面研究汇总了2011年、2012年和2015年巴西全国健康与 Wellness 调查的数据(n = 36,000)。被诊断患有CU并接受治疗的受访者(年龄≥18岁)提供了有关人口统计学、健康史、使用简短版SF-36v2评估的HRQoL(心理和身体健康状况)、心理投诉情况、工作障碍、活动障碍和HRU的数据。采用广义线性模型,并控制协变量,研究接受CU治疗的患者与匹配的对照组在结局变量上的差异。

结果

确诊CU的患病率为0.41%(n = 249),接受治疗的CU患病率为0.21%(n = 127)。经过调整后,与对照组相比,CU(目前正在接受CU治疗)与较差的心理功能、身体功能和健康效用相关(所有p < 0.01)。与对照组相比,CU出现焦虑和睡眠困难的几率高出两倍多,工作和活动障碍的几率高出1.5倍多,总就诊次数是对照组的两倍,过敏专科医生就诊次数是对照组的八倍,急诊就诊次数是对照组的两倍(所有p < 0.01)。

结论

与匹配的普通人群对照组相比,许多使用处方治疗的CU患者经历了焦虑和睡眠障碍、较差的HRQoL、严重的工作和活动障碍以及高HRU。研究结果表明,巴西对更有效的CU治疗和管理存在未满足的需求。

资金来源

诺华制药公司和基因泰克公司。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a03e/5698196/4dff2ad19f0e/13555_2017_191_Fig1_HTML.jpg

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