Bernstein Jonathan A, Winders Tonya A, McCarthy Jessica, Saraswat Pallavi, Chapman-Rothe Nadine, Raftery Tara, Weller Karsten
Division of Allergy and Immunology, University of Cincinnati, Cincinnati, OH, USA.
Advanced Allergy Services, LLC and Bernstein Allergy Group and Clinical Research Center, Cincinnati, OH, USA.
Dermatol Ther (Heidelb). 2025 Aug;15(8):2201-2215. doi: 10.1007/s13555-025-01461-8. Epub 2025 Jun 22.
Chronic spontaneous urticaria (CSU) is characterized by itchy wheals/hives and/or angioedema lasting longer than 6 weeks. Herein, we describe patients' perspectives from the global Urticaria Voices study reporting treatment patterns, disease burden, treatment satisfaction, and expectations.
This global, cross-sectional online survey was conducted from February to September 2022 in patients with CSU. Eligible patients had a self-reported clinician-provided diagnosis of CSU. Data were analyzed descriptively and reported as percentages (n/N), means (standard deviation [SD]), or 95% confidence intervals.
Overall, 582 patients with CSU were included in this analysis (62% women; mean [SD] age: 42.0 [11.9] years). At the time of the survey, patients reported taking 2.9 (2.6) concomitant therapies; most patients (79%) were prescribed H1-antihistamines (H1-AH), of which 42% took first-generation H1-AH and 52% took second-generation H1-AH. Since the initiation of their first prescribed treatment (6.3 [8.2] years), 80% of patients reported H1-AH switching (2.3 times on average), 62% of whom reported up-dosing (2.9 times on average). In addition, 50% reported currently using glucocorticoids (cream: 72.1%; oral: 48.3%; injection: 25.5%) and 33% reported using any biologic (omalizumab: 26%; dupilumab: 16%): montelukast (18%), doxepin (16%), or ciclosporin (16%). Apart from their prescribed treatments, patients reported currently using additional services (dietetic consultations: 21%, psychological support: 19%) and self-care strategies (e.g., using topical creams, avoiding certain clothing and foods) for CSU management. Most patients (65%) reported that their current treatments did not adequately control their CSU symptoms. Overall, 37% of patients reported experiencing stress due to the unpredictable nature of the disease.
Despite H1-antihistamine switching and up-dosing, most patients (84%) had inadequately controlled disease. Approximately one-quarter of inadequately controlled patients were escalated to more effective treatments such as biologics. These results suggest a need for additional treatment options for patients with inadequately controlled CSU to provide sustained symptom relief.
慢性自发性荨麻疹（CSU）的特征是瘙痒性风团/风疹块和/或血管性水肿持续超过6周。在此，我们描述了全球荨麻疹之声研究中患者对于治疗模式、疾病负担、治疗满意度和期望的看法。
这项全球横断面在线调查于2022年2月至9月对CSU患者进行。符合条件的患者有临床医生提供的CSU自我报告诊断。数据进行描述性分析，并以百分比（n/N）、均值（标准差[SD]）或95%置信区间报告。
总体而言，本分析纳入了582例CSU患者（62%为女性；平均[SD]年龄：42.0[11.9]岁）。在调查时，患者报告正在服用2.9（2.6）种联合疗法；大多数患者（79%）被处方使用H1抗组胺药（H1-AH），其中42%服用第一代H1-AH，52%服用第二代H1-AH。自首次开始规定治疗以来（6.3[8.2]年），80%的患者报告更换过H1-AH（平均2.3次），其中62%报告增加过剂量（平均2.9次）。此外，50%的患者报告目前正在使用糖皮质激素（乳膏：72.1%；口服：48.3%；注射：25.5%），33%的患者报告使用过任何生物制剂（奥马珠单抗：26%；度普利尤单抗：16%）、孟鲁司特（18%）、多塞平（16%）或环孢素（16%）。除了规定的治疗外，患者报告目前还使用其他服务（饮食咨询：21%，心理支持：19%）和自我护理策略（如使用外用乳膏、避免某些衣物和食物）来管理CSU。大多数患者（65%）报告他们目前的治疗未能充分控制CSU症状。总体而言，37%的患者报告由于疾病的不可预测性而感到压力。
尽管更换了H1抗组胺药并增加了剂量，但大多数患者（84%）的疾病仍未得到充分控制。约四分之一控制不佳的患者升级接受了更有效的治疗，如生物制剂。这些结果表明，对于CSU控制不佳的患者，需要更多的治疗选择来持续缓解症状。
