Rossi Oliviero, Piccirillo Angelo, Iemoli Enrico, Patrizi Annalisa, Stingeni Luca, Calvieri Stefano, Gola Massimo, Dapavo Paolo, Cristaudo Antonio, Zichichi Leonardo, Losappio Laura, Saccheri Fabiana, Pastorello Elide Anna
Azienda Ospedaliera Universitaria Careggi, SOD Immunoallergologia, Florence, Italy.
AO Ospedale San Carlo di Potenza, Italy.
World Allergy Organ J. 2020 Dec 8;13(12):100470. doi: 10.1016/j.waojou.2020.100470. eCollection 2020 Dec.
In Italy, the real-world evidence on the extent of adherence to guidelines and the benefits of recommended therapeutic medications and their impact on the quality of life (QoL) of H-antihistamines (H-AH) refractory chronic urticaria (CU) patients is limited.
AWARE (A World-wide Antihistamine-Refractory chronic urticaria patient Evaluation) was a global prospective, non-interventional study of CU in real-world setting which included patients aged ≥18 years with a medically confirmed diagnosed of CU present for more than 2 months. In this study, the disease characteristics, pharmacological treatments and patient-reported outcomes (PROs) are reported.
In total, 159 patients from 24 study centres in Italy completed the study. At baseline, 221 (89.5%) and 8 (3.2%) patients had chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU), respectively, while 18 (7.3%) patients had concomitant CSU and CIndU. For CSU patients, mean dermatology life quality index and CU quality of life questionnaire scores reduced to 3.0 ± 4.9 and 14.6 ± 18.6 at Month 24 from baseline scores of 7.5 ± 6.6 and 33.2 ± 19.5, respectively, indicating an improvement in QoL. This was reflected in their work-life as work productivity impairment reduced considerably after 2 years. Only 71.9% CSU patients had a prior treatment, while during the study, 96.8% of the patients were treated with a medication. At baseline, only 52.9% CSU patients reported nonsedating H-antihistamines as first-line of treatment in prior medication, this increased to 89.6% during current medication.
This study shows that CSU has a considerable socio-economic burden and an improvement in QoL can be achieved in CSU patients if an appropriate therapeutic path is followed.
在意大利,关于遵循指南的程度、推荐治疗药物的益处及其对H - 抗组胺药(H - AH)难治性慢性荨麻疹(CU)患者生活质量(QoL)影响的真实世界证据有限。
AWARE(全球抗组胺药难治性慢性荨麻疹患者评估)是一项在真实世界环境中对CU进行的全球前瞻性、非干预性研究,纳入了年龄≥18岁、经医学确诊患有CU且病程超过2个月的患者。本研究报告了疾病特征、药物治疗和患者报告结局(PROs)。
意大利24个研究中心的159名患者完成了该研究。基线时,分别有221名(89.5%)和8名(3.2%)患者患有慢性自发性荨麻疹(CSU)和慢性诱导性荨麻疹(CIndU),而18名(7.3%)患者同时患有CSU和CIndU。对于CSU患者,在第24个月时,皮肤病生活质量指数和CU生活质量问卷评分分别从基线时的7.5±6.6和33.2±19.5降至3.0±4.9和14.6±18.6,表明生活质量有所改善。这反映在他们的工作生活中,因为2年后工作效率损害大幅降低。只有71.9%的CSU患者曾接受过治疗,而在研究期间,96.8%的患者接受了药物治疗。基线时,只有52.9%的CSU患者在先前用药中将非镇静性H - 抗组胺药作为一线治疗药物,在当前用药期间这一比例增至89.6%。
本研究表明,CSU具有相当大的社会经济负担,如果遵循适当的治疗路径,CSU患者的生活质量可以得到改善。