Rubeiz Christine J, Asero Ricardo, Betschel Stephen, Craig Timothy, Grumach Anete, Hide Michihiro, Lang David, Levin Michael, Longhurst Hilary, Magan Eli, Maurer Marcus, Saini Romi, Sussman Gordon, Toubi Elias, Van Dinh Nguyen, Zuberier Torsten, Bernstein Jonathan A
Cincinnati Children's Hospital Medical Center, Division of Allergy and Immunology, Cincinnati, OH, USA.
Ambulatorio di Allergologia, Clinica San Carlo, Pademo Dugnano, Italy.
World Allergy Organ J. 2024 Jan 3;17(1):100858. doi: 10.1016/j.waojou.2023.100858. eCollection 2024 Jan.
Chronic spontaneous urticaria (CSU) is a common condition treated by allergist/immunologists, but the only FDA-approved biologic medication, omalizumab, may be underutilized globally.
This study was performed to determine the global prescription of omalizumab for treatment of CSU by allergists/immunologists.
Anonymous questionnaire surveys were distributed online to World Allergy Organization (WAO) members worldwide. Categorical data were analyzed for descriptive analysis using one-way frequency tabulation in SAS 9.4.
There were 348 respondents (43 missing data); Average age 51 (range 28-90); M/F 48%/52%. 58% had > 15 years of clinical experience and 10% < 5; 42% worked in private clinics, 36% public hospitals, 24% academia, 18% private hospitals, and 4% in community practice. Eighty-two percent (82%) prescribed omalizumab for CSU patients and use of omalizumab was highest among young practitioners. The most significant barriers were cost (63%) and restricted formulary (24%). Drug safety (63%) and chances of adverse events (47%) were the most significant factors deciding treatment. Twenty-two percent (22%) reported 80-100% of CSU patients were complete responders to omalizumab; 34% preferred increasing frequency (q 2-weeks), and 18% preferred increasing dose (600 mg q 4-weeks) for partial or non-responders. UAS7, UCT, and CU-QoL were used to assess CSU by 55%, 29%, and 25% of respondents, respectively. Autoimmune thyroid disease (62%), thyroid abnormality (43%) and allergic rhinitis (35%) were the most frequent comorbidities reported.
Most clinicians favored omalizumab over other potential treatments due to safety. Although younger clinicians were more likely to prescribe omalizumab, cost and formulary access were major barriers. Only 22% of respondents reported 80% or greater of their patients had complete response to omalizumab, indicating the need for novel CSU therapies.
慢性自发性荨麻疹（CSU）是过敏症专科医生/免疫学家治疗的常见病症，但全球唯一获得美国食品药品监督管理局（FDA）批准的生物药物奥马珠单抗的使用可能未得到充分利用。
本研究旨在确定过敏症专科医生/免疫学家在全球范围内使用奥马珠单抗治疗CSU的处方情况。
向全球范围内的世界过敏组织（WAO）成员在线发放匿名问卷调查。使用SAS 9.4中的单向频率列表对分类数据进行描述性分析。
共有348名受访者（43人有缺失数据）；平均年龄51岁（范围28 - 90岁）；男女比例为48%/52%。58%的人有超过15年的临床经验，10%的人临床经验少于5年；42%在私人诊所工作，36%在公立医院工作，24%在学术界工作，18%在私立医院工作，4%在社区诊所工作。82%的人会为CSU患者开具奥马珠单抗，年轻从业者中奥马珠单抗的使用率最高。最主要的障碍是成本（63%）和处方受限（24%）。药物安全性（63%）和不良事件发生几率（47%）是决定治疗的最重要因素。22%的人报告称80 - 100%的CSU患者对奥马珠单抗完全有效；对于部分有效或无效的患者，34%的人倾向增加用药频率（每2周一次），18%的人倾向增加剂量（每4周600毫克）。分别有55%、29%和25%的受访者使用UAS7、UCT和CU - QoL来评估CSU。自身免疫性甲状腺疾病（62%）、甲状腺异常（43%）和过敏性鼻炎（35%）是报告中最常见的合并症。
由于安全性，大多数临床医生更倾向于使用奥马珠单抗而非其他潜在治疗方法。尽管年轻临床医生更有可能开具奥马珠单抗，但成本和获取处方是主要障碍。只有22%的受访者报告称其80%或更多患者对奥马珠单抗完全有效，这表明需要新的CSU治疗方法。
