Department of Clinical Immunology and Allergy, St James's University Hospital, Leeds, UK.
The Eden Unit, University Hospitals Plymouth NHS Trust, Plymouth, UK.
Clin Exp Dermatol. 2020 Dec;45(8):1003-1010. doi: 10.1111/ced.14230. Epub 2020 Aug 26.
Chronic urticaria (CU) is a skin condition characterized by repeated occurrence of itchy weals and/or angio-oedema for > 6 weeks.
To provide data demonstrating the real-life burden of CU in the UK.
This UK subset of the worldwide, prospective, noninterventional AWARE study included patients aged 18-75 years diagnosed with H1-antihistamine (H1-AH)-refractory chronic spontaneous urticaria (CSU) for > 2 months. Baseline characteristics, disease activity, treatments, comorbidities and healthcare resource use were documented. Quality of life (QoL), work productivity and activity impairment were assessed.
Baseline analysis included 252 UK patients. Mean age and body mass index were 45.0 years and 29.0 kg/m , respectively. Most patients were female (77.8%) and had moderate/severe disease activity (mean Urticaria Activity Score over 7 days was 18.4) and a 'spontaneous' component to their CU (73.4% CSU; 24.6% CSU and chronic inducible urticaria). Common comorbidities included depression/anxiety (24.6%), asthma (23.8%) and allergic rhinitis (12.7%). A previous treatment was recorded for 57.9% of patients. Mean Dermatology Life Quality Index score was 9.5, and patients reported impairments in work productivity and activity. Healthcare resource use was high. Severity of CSU was associated with female sex, obesity, anxiety and diagnosis. Only 28.5% of patients completed all nine study visits, limiting analysis of long-term treatment patterns and disease impact.
Adult H1-AH-refractory patients with CU in the UK reported high rates of healthcare resource use and impairment in QoL, work productivity and activity at baseline. The differing structures of UK healthcare may explain the high study discontinuation rates versus other countries.
慢性荨麻疹（CU）是一种以反复出现瘙痒性风团和/或血管性水肿超过 6 周为特征的皮肤疾病。
提供数据证明英国 CU 的实际负担。
这项在全球范围内进行的、前瞻性的、非干预性的 AWARE 研究的英国子研究纳入了年龄在 18-75 岁之间、诊断为 H1 抗组胺药（H1-AH）难治性慢性自发性荨麻疹（CSU）超过 2 个月的患者。记录了基线特征、疾病活动度、治疗方法、合并症和医疗资源的使用情况。评估了生活质量（QoL）、工作生产力和活动能力受损情况。
基线分析包括 252 名英国患者。平均年龄和体重指数分别为 45.0 岁和 29.0kg/m²。大多数患者为女性（77.8%），疾病活动度为中重度（平均 7 天的荨麻疹活动评分 18.4），且 CU 有“自发性”成分（73.4%CSU；24.6%CSU 和慢性诱导性荨麻疹）。常见的合并症包括抑郁/焦虑（24.6%）、哮喘（23.8%）和过敏性鼻炎（12.7%）。57.9%的患者有既往治疗记录。平均皮肤病生活质量指数（Dermatology Life Quality Index，DLQI）评分为 9.5，患者报告工作生产力和活动能力受损。医疗资源的使用量较高。CSU 的严重程度与女性、肥胖、焦虑和诊断有关。只有 28.5%的患者完成了所有 9 次研究访视，这限制了对长期治疗模式和疾病影响的分析。
英国 H1-AH 难治性 CU 成年患者在基线时报告了高频率的医疗资源使用和 QoL、工作生产力和活动能力受损情况。英国医疗保健结构的差异可能解释了与其他国家相比，研究中断率较高的原因。
