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俄罗斯针对对H1抗组胺药难治的慢性荨麻疹的治疗:来自AWARE研究的数据。

Treating chronic urticaria refractory to H1-antihistamines in Russia: data from the AWARE study.

作者信息

Danilycheva Inna, Emelyanov Alexander, Meshkova Raisa, Ukhanova Olga, Abdrakhmanov Azat, Litvin Loliana

机构信息

Department of Allergology and Immunotherapy, NRC Institute of Immunology FMBA of Russia, Moscow, Russia.

Department of Respiratory Medicine and Allergy, North-Western Medical University, Saint Petersburg, Russia.

出版信息

Postepy Dermatol Alergol. 2022 Jun;39(3):509-516. doi: 10.5114/ada.2022.117556. Epub 2022 Jul 14.

Abstract

INTRODUCTION

Data on burden and treatment outcomes of chronic spontaneous urticaria (CSU) in Russia are limited. Poor adherence to recommended treatments can lead to suboptimal management of CSU patients.

AIM

To understand disease burden, treatment algorithms, and outcomes of CSU in the Russian cohort of the AWARE study.

MATERIAL AND METHODS

AWARE was a global prospective, non-interventional study of chronic urticaria in the real-world setting. Adult patients with H1-antihistamines (H1AH)-refractory CSU for ≥ 2 months were included. Disease characteristics, quality of life (QoL), healthcare resource utilisation (HRU), and pharmacological treatments were observed during the 2-year study period.

RESULTS

Of the 135 patients enrolled from Russia, 121 completed the study. Pre-baseline, ~37% of patients were managed with non-recommended treatments (33% treated with sedative H1AH; 4% with other non-recommended treatments) and 28.2% of patients were not treated for CSU. There was a reduction in the use of sedative H1AH during the study (0.9% of patients treated with sedative H1AHs at Year 2). Decreased disease activity was seen as early as 3 months and continued to improve over 2 years (Urticaria Activity Score over 7 days (UAS7): 20.2 at baseline ( = 124) to 10.1, 7.1, and 3.2 at month 3 ( = 118), 12 ( = 109), and 24 ( = 109), respectively). This corresponded with QoL improvements (dermatology life quality index (DLQI) score: 10.3 at baseline to 5.4, 3.6, and 2.3 at Month 3 ( = 75), 12 ( = 98), and 24 ( = 92), respectively), and reduced angioedema and hives throughout the study.

CONCLUSIONS

The burden of CSU in Russia is high, contributing to increased HRU. Guideline-recommended treatments and systematic escalation of therapy to achieve complete symptom control can improve management of patients with CSU.

摘要

引言

俄罗斯关于慢性自发性荨麻疹(CSU)的负担和治疗结果的数据有限。对推荐治疗方案的依从性差可能导致CSU患者的管理效果欠佳。

目的

了解AWARE研究俄罗斯队列中CSU的疾病负担、治疗方案及结果。

材料与方法

AWARE是一项在现实环境中对慢性荨麻疹进行的全球前瞻性非干预性研究。纳入了对H1抗组胺药(H1AH)难治性CSU≥2个月的成年患者。在为期2年的研究期间观察疾病特征、生活质量(QoL)、医疗资源利用(HRU)和药物治疗情况。

结果

从俄罗斯纳入的135例患者中,121例完成了研究。基线前,约37%的患者接受了非推荐治疗(33%接受镇静性H1AH治疗;4%接受其他非推荐治疗),28.2%的患者未接受CSU治疗。研究期间镇静性H1AH的使用有所减少(第2年接受镇静性H1AH治疗的患者为0.9%)。疾病活动度早在3个月时就开始下降,并在2年期间持续改善(7天荨麻疹活动评分(UAS7):基线时为20.2(n = 124),第3个月时为10.1、第12个月时为7.1、第24个月时为3.2(n分别为118、109和109))。这与生活质量的改善相对应(皮肤病生活质量指数(DLQI)评分:基线时为10.3,第3个月时为5.4、第12个月时为3.6、第24个月时为2.3(n分别为75、98和92)),并且在整个研究过程中血管性水肿和荨麻疹均减少。

结论

俄罗斯CSU的负担较高,导致医疗资源利用增加。指南推荐的治疗方案以及为实现症状完全控制而进行的系统治疗升级可改善CSU患者的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7066/9326929/75bfdbe87d67/PDIA-39-47336-g001.jpg

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