Gonçalo M, Gimenéz-Arnau A, Al-Ahmad M, Ben-Shoshan M, Bernstein J A, Ensina L F, Fomina D, Galvàn C A, Godse K, Grattan C, Hide M, Katelaris C H, Khoshkhui M, Kocatürk E, Kulthanan K, Medina I, Nasr I, Peter J, Staubach P, Wang L, Weller K, Maurer M
Department of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
Department of Dermatology, Hospital del Mar, IMIM, Universitat Autònoma, Barcelona, Spain.
Br J Dermatol. 2021 Feb;184(2):226-236. doi: 10.1111/bjd.19561. Epub 2020 Nov 2.
Chronic urticaria (CU) affects about 1% of the world population of all ages, mostly young and middle-aged women. It usually lasts for several years (> 1 year in 25-75% of patients) and often takes > 1 year before effective management is implemented. It presents as chronic spontaneous urticaria (CSU), chronic inducible urticaria (CIndU) or both in the same person. More than 25% of cases are resistant to H -antihistamines, even at higher doses, and third- and fourth-line therapies (omalizumab and ciclosporin) control the disease only in two-thirds of H -antihistamine-resistant patients. Here we review the impact of CU on different aspects of patients' quality of life and the burden of this chronic disease for the patient and society. CU may have a strong impact on health-related quality of life (HRQoL), particularly when CSU is associated with angio-oedema and/or CIndU (Dermatology Life Quality Index > 10 in 30% of patients). Comorbidities, such as anxiety and depression, which are present in more than 30% of patients with CSU, compound HRQoL impairment. Severe pruritus and the unpredictable occurrence of weals and angio-oedema are responsible for sleep disorders; sexual dysfunction; limitations on daily life, work and sports activities; interfering with life within the family and in society; and patients' performance at school and work (6% absenteeism and 25% presenteeism). Apart from treatment costs, with annual values between 900 and 2400 purchasing power parity dollars (PPP$) in Europe and the USA, CU is associated with a high consumption of medical resources and other indirect costs, which may reach a total annual cost of PPP$ 15 550.
慢性荨麻疹（CU）影响着全球各年龄段约1%的人口，其中大多数为中青年女性。它通常会持续数年（25%-75%的患者病程超过1年），且往往在实施有效治疗前已持续超过1年。其表现形式为慢性自发性荨麻疹（CSU）、慢性诱导性荨麻疹（CIndU）或同一患者身上两者皆有。超过25%的病例对H1抗组胺药耐药，即便使用高剂量药物，三线和四线治疗药物（奥马珠单抗和环孢素）也仅能控制三分之二对H1抗组胺药耐药患者的病情。在此，我们综述CU对患者生活质量不同方面的影响以及这种慢性病给患者和社会带来的负担。CU可能会对健康相关生活质量（HRQoL）产生重大影响，尤其是当CSU伴有血管性水肿和/或CIndU时（30%的患者皮肤病生活质量指数>10）。超过30%的CSU患者存在焦虑和抑郁等合并症，这加剧了HRQoL受损。严重瘙痒以及风团和血管性水肿的不可预测发作会导致睡眠障碍、性功能障碍、日常生活、工作和体育活动受限、干扰家庭和社会生活以及患者在学校和工作中的表现（缺勤率6%，出勤但工作效率低下率25%）。除了治疗费用（在欧洲和美国，每年价值900至2400购买力平价美元（PPP$））外，CU还与高医疗资源消耗及其他间接成本相关，每年总成本可能达到15550 PPP$。
