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Cherrez-Ojeda I, Vanegas E, Cherrez A, Felix M, Weller K, Magerl M, Maurer RR, Mata VL, Kasperska-Zajac A, Sikora A, Fomina D, Kovalkova E, Godse K, Rao ND, Khoshkhui M, Rastgoo S, Criado RFJ, Abuzakouk M, Grandon D, Van Doorn MB, Oliveira Rodrigues Valle S, De Souza Lima EM, Thomsen SF, Ramón GD, Matos Benavides EE, Bauer A, Giménez-Arnau AM, Kocatürk E, Guillet C, Larco JI, Zhao ZT, Makris M, Ritchie C, Xepapadaki P, Ensina LF, Cherrez S, Maurer M. How are patients with chronic urticaria interested in using information and communication technologies to guide their healthcare? A UCARE study. World Allergy Organ J 2021; 14:100542. [PMID: 34141048 PMCID: PMC8190491 DOI: 10.1016/j.waojou.2021.100542] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/26/2021] [Accepted: 04/09/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Patients with chronic urticaria (CU) are increasingly using information and communication technologies (ICTs) to manage their health. What CU patients expect from ICTs and which ICTs they prefer remains unknown. We assessed why CU patients use ICTs, which ones they prefer, and what drives their expectations and choices. METHODS In this cross-sectional study, 1841 patients across 17 countries were recruited at UCAREs (Urticaria Centers of Reference and Excellence). Patients with CU who were >12 years old completed a 23-item questionnaire. RESULTS Most patients were interested in receiving disease information (87.3%), asking physicians about CU (84.1%), and communicating with other patients through ICTs (65.6%). For receiving disease information, patients preferred one-to-one and one-to-many ICTs, especially web browsers. One-to-one ICTs were also the ICTs of choice for asking physicians about urticaria and for communicating with other patients, and e-mail and WhatsApp were the preferred ICTs, respectively. Many-to-many ICTs such as Facebook, Instagram, LinkedIn, and Twitter were least preferred for all 3 purposes. Living in rural areas and higher education were linked to higher odds of being interested in receiving disease information, asking physicians, and communicating with patients through ICTs. CONCLUSIONS Most patients and especially patients with higher education who live in rural areas are interested in using ICTs for their healthcare, but prefer different ICTs for different purposes, ie, web browsers for obtaining information, e-mail for asking physicians, and WhatsApp for communicating with other patients. Our findings may help to improve ICTs for CU.
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Affiliation(s)
- Ivan Cherrez-Ojeda
- Universidad Espíritu Santo, Samborondón, Ecuador
- Respiralab, Respiralab Research Group, Guayaquil, Ecuador
| | - Emanuel Vanegas
- Universidad Espíritu Santo, Samborondón, Ecuador
- Respiralab, Respiralab Research Group, Guayaquil, Ecuador
| | - Annia Cherrez
- Respiralab, Respiralab Research Group, Guayaquil, Ecuador
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Miguel Felix
- Universidad Espíritu Santo, Samborondón, Ecuador
- Respiralab, Respiralab Research Group, Guayaquil, Ecuador
| | - Karsten Weller
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany
| | - Markus Magerl
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany
| | - Rasmus Robin Maurer
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany
| | - Valeria L. Mata
- Universidad Espíritu Santo, Samborondón, Ecuador
- Respiralab, Respiralab Research Group, Guayaquil, Ecuador
| | - Alicja Kasperska-Zajac
- European Center for Diagnosis and Treatment of Urticaria, Medical University of Silesia, Katowice, Poland
| | - Agnieszka Sikora
- European Center for Diagnosis and Treatment of Urticaria, Medical University of Silesia, Katowice, Poland
| | - Daria Fomina
- City Center of Allergy and Immunology, Clinical City Hospital #52, Moscow, Russia
- Department of Allergology and Clinical Immunology, I.M. Sechenov First Moscow State Medical University, Trubetskaya St., 8/2, Moscow, 119991, Russian Federation
| | - Elena Kovalkova
- City Center of Allergy and Immunology, Clinical City Hospital #52, Moscow, Russia
| | - Kiran Godse
- Department of Dermatology, D Y, Patil University School of Medicine and Hospital, Mumbai, India
| | - Nimmagadda Dheeraj Rao
- Department of Dermatology, D Y, Patil University School of Medicine and Hospital, Mumbai, India
| | - Maryam Khoshkhui
- Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Allergy and Immunology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sahar Rastgoo
- Department of Allergy and Immunology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Roberta FJ. Criado
- Department of Dermatology, Faculdade de Medicina do ABC, São Paulo, Brazil
| | - Mohamed Abuzakouk
- Allergy and Immunology Department, Cleveland Clinic Abu Dhabi, United Arab Emirates
| | - Deepa Grandon
- Allergy and Immunology Department, Cleveland Clinic Abu Dhabi, United Arab Emirates
| | | | | | | | - Simon Francis Thomsen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Biomedical Sciences, Copenhagen, Denmark
| | - German D. Ramón
- Instituto de Alergia e Inmunología del Sur, Bahía Blanca, Prov. De Buenos Aires, Argentina
| | | | - Andrea Bauer
- Department of Dermatology, University Allergy Center, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | - Ana M. Giménez-Arnau
- Department of Dermatology, Hospital del Mar, IMIM, Universitat Autònoma, Barcelona, Spain
| | - Emek Kocatürk
- Department of Dermatology, Koç University School of Medicine, Istanbul, Turkey
| | - Carole Guillet
- Department of Dermatology, University Hospital Zurich, Switzerland
| | | | - Zuo-Tao Zhao
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China
| | - Michael Makris
- Allergy Unit, 2nd Department of Dermatology and Venereology, National and Kapodistrian, University of Athens, “Attikon” University Hospital, Greece
| | - Carla Ritchie
- Allergy Division, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Paraskevi Xepapadaki
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Greece
| | | | - Sofia Cherrez
- Respiralab, Respiralab Research Group, Guayaquil, Ecuador
- Department of Dermatology, SRH Zentralklinikum Suhl, Germany
| | - Marcus Maurer
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany
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Wagner N, Zink A, Hell K, Reinhardt M, Romer K, Hillmann E, Baeumer D, Schielein MC. Patients with Chronic Urticaria Remain Largely Undertreated: Results from the DERMLINE Online Survey. Dermatol Ther (Heidelb) 2021; 11:1027-1039. [PMID: 33945120 PMCID: PMC8163939 DOI: 10.1007/s13555-021-00537-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/16/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction Chronic urticaria (CU) is an unpredictable disease, with high disease burden and a significant negative impact on quality of life, especially in patients of working age. Many patients are undertreated, and there is poor awareness of strategies to manage patients with CU in the real-world setting. The current study aimed to gain a better understanding of CU from the patients’ perspective, including the body areas most affected by wheals and angioedema, the disease burden and current use of the healthcare system. Methods A nationwide online survey was performed in Germany involving individuals who reported a diagnosis of CU and experienced symptoms within 3 months prior to inclusion. Results This self-report survey included 1037 participants (89.2% female), with a mean ± standard deviation (SD) age of 33.4 ± 11.0 years and a mean ± SD disease duration of 10.0 ± 9.4 years. On average, participants suffered from urticaria symptoms for 3.0 ± 4.3 years before diagnosis. In 73% of participants, symptoms worsened due to external factors, with the majority specifying stress in their personal life or work-related stress as eliciting factors. Within the previous 3 months, 87.4 and 44.1% of participants experienced wheals and angioedema, respectively, at multiple body areas, and most (79.6%) participants had uncontrolled symptoms as measured with the Urticaria Control Test. Despite the high burden of disease, 60.3% of participants stated that they were not currently receiving treatment. The most commonly used therapies to treat CU were oral (72.8%) and non-prescription (43.3%) and prescription (47.3%) topical drugs, with 18.0% of the participants receiving injectable/infused drugs. Conclusion The majority of the participants responding to the survey reported that CU is not sufficiently controlled, thereby severely influencing a highly productive time in their life. The body areas most affected by wheals and angioedema are specified, based on data provided by a large group of affected participants. A greater awareness of disease burden and available treatment options is needed. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-021-00537-5.
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Affiliation(s)
- Nicola Wagner
- Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - Alexander Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Katharina Hell
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig Maximilian University (LMU), Munich, Germany
| | | | | | | | | | - Maximilian C Schielein
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
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3
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Maurer M, Weller K, Magerl M, Maurer RR, Vanegas E, Felix M, Cherrez A, Mata VL, Kasperska-Zajac A, Sikora A, Fomina D, Kovalkova E, Godse K, Rao ND, Khoshkhui M, Rastgoo S, Criado RFJ, Abuzakouk M, Grandon D, van Doorn M, Valle SOR, de Souza Lima EM, Thomsen SF, Ramón GD, Matos Benavides EE, Bauer A, Giménez-Arnau AM, Kocatürk E, Guillet C, Ignacio Larco J, Zhao ZT, Makris M, Ritchie C, Xepapadaki P, Ensina LF, Cherrez S, Cherrez-Ojeda I. The usage, quality and relevance of information and communications technologies in patients with chronic urticaria: A UCARE study. World Allergy Organ J 2020; 13:100475. [PMID: 33204387 PMCID: PMC7606865 DOI: 10.1016/j.waojou.2020.100475] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/10/2020] [Accepted: 09/24/2020] [Indexed: 11/04/2022] Open
Abstract
Background Chronic urticaria (CU) is characterized by itchy recurrent wheals, angioedema, or both for 6 weeks or longer. CU can greatly impact patients' physical and emotional quality of life. Patients with chronic conditions are increasingly seeking information from information and communications technologies (ICTs) to manage their health. The objective of this study was to assess the frequency of usage and preference of ICTs from the perspective of patients with CU. Methods In this cross-sectional study, 1800 patients were recruited from primary healthcare centers, university hospitals or specialized clinics that form part of the UCARE (Urticaria Centers of Reference and Excellence) network throughout 16 countries. Patients were >12 years old and had physician-diagnosed chronic spontaneous urticaria (CSU) or chronic inducible urticaria (CIndU). Patients completed a 23-item questionnaire containing questions about ICT usage, including the type, frequency, preference, and quality, answers to which were recorded in a standardized database at each center. For analysis, ICTs were categorized into 3 groups as follows: one-to-one: SMS, WhatsApp, Skype, and email; one-to-many: YouTube, web browsers, and blogs or forums; many-to-many: Instagram, Twitter, Facebook, and LinkedIn. Results Overall, 99.6% of CU patients had access to ICT platforms and 96.7% had internet access. Daily, 85.4% patients used one-to-one ICT platforms most often, followed by one-to-many ICTs (75.5%) and many-to-many ICTs (59.2%). The daily ICT usage was highest for web browsers (72.7%) and WhatsApp (70.0%). The general usage of ICT platforms increased in patients with higher levels of education. One-to-many was the preferred ICT category for obtaining general health information (78.3%) and for CU-related information (75.4%). A web browser (77.6%) was by far the most commonly used ICT to obtain general health information, followed by YouTube (25.8%) and Facebook (16.3%). Similarly, for CU-specific information, 3 out of 4 patients (74.6%) used a web browser, 20.9% used YouTube, and 13.6% used Facebook. One in 5 (21.6%) patients did not use any form of ICT for obtaining information on CU. The quality of the information obtained from one-to-many ICTs was rated much more often as very interesting and of good quality for general health information (53.5%) and CU-related information (51.5%) as compared to the other categories. Conclusions Usage of ICTs for health and CU-specific information is extremely high in all countries analyzed, with web browsers being the preferred ICT platform.
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Key Words
- (3–5) ICT
- Apps, applications
- CIndU, chronic inducible urticaria
- CSU, chronic spontaneous urticaria
- CU, chronic urticaria
- HCP, healthcare provider
- ICT, information and communications technologies
- Information and communications technology
- SEM, self-management education
- SMS, short messaging service
- Self-management
- UAE, United Arab Emirates
- UCARE, Urticaria Centers of Reference and Excellence
- Urticaria
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Affiliation(s)
- Marcus Maurer
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany
| | - Karsten Weller
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany
| | - Markus Magerl
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany
| | - Rasmus Robin Maurer
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany
| | - Emanuel Vanegas
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respiralab, Respiralab Research Group, Guayaquil, Ecuador
| | - Miguel Felix
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respiralab, Respiralab Research Group, Guayaquil, Ecuador
| | - Annia Cherrez
- Respiralab, Respiralab Research Group, Guayaquil, Ecuador.,Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Valeria L Mata
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respiralab, Respiralab Research Group, Guayaquil, Ecuador
| | - Alicja Kasperska-Zajac
- European Center for Diagnosis and Treatment of Urticaria, Medical University of Silesia, Katowice, Poland
| | - Agnieszka Sikora
- European Center for Diagnosis and Treatment of Urticaria, Medical University of Silesia, Katowice, Poland
| | - Daria Fomina
- City Center of Allergy and Immunology, Clinical City Hospital #52, Moscow, Russia.,Department of Allergology and Clinical Immunology, I.M. Sechenov First Moscow State Medical University, Trubetskaya St., 8/2, Moscow, 119991, Russian Federation
| | - Elena Kovalkova
- City Center of Allergy and Immunology, Clinical City Hospital #52, Moscow, Russia
| | - Kiran Godse
- Department of Dermatology, D Y, Patil University School of Medicine and Hospital, Mumbai, India
| | - Nimmagadda Dheeraj Rao
- Department of Dermatology, D Y, Patil University School of Medicine and Hospital, Mumbai, India
| | - Maryam Khoshkhui
- Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Allergy and Immunology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sahar Rastgoo
- Department of Allergy and Immunology, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mohamed Abuzakouk
- Allergy and Immunology Department, Cleveland Clinic Abu Dhabi, The Uae
| | - Deepa Grandon
- Allergy and Immunology Department, Cleveland Clinic Abu Dhabi, The Uae
| | | | | | | | - Simon Francis Thomsen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Biomedical Sciences, Copenhagen, Denmark
| | - German D Ramón
- Instituto de Alergia e Inmunología del Sur, Bahía Blanca, De Buenos Aires, Argentina
| | - Edgar E Matos Benavides
- Centro de Referencia de Alergia, Asma e Inmunología - Instituto Nacional del Niño, Lima-Perú
| | - Andrea Bauer
- Department of Dermatology, University Allergy Center, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | | | - Emek Kocatürk
- Department of Dermatology, Koç University School of Medicine, Istanbul, Turkey
| | - Carole Guillet
- Department of Dermatology, University Hospital Zurich, Switzerland
| | | | - Zuo-Tao Zhao
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China
| | - Michael Makris
- Allergy Unit, 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, "Attikon" University Hospital, Greece
| | - Carla Ritchie
- Allergy Division, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Paraskevi Xepapadaki
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Greece
| | | | - Sofia Cherrez
- Department of Dermatology, SRH Zentralklinikum Suhl, Germany.,Respiralab, Respiralab Research Group, Guayaquil, Ecuador
| | - Ivan Cherrez-Ojeda
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respiralab, Respiralab Research Group, Guayaquil, Ecuador
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4
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Lapeere H, Baeck M, Stockman A, Sabato V, Grosber M, Moutschen M, Lambert J, Vandebuerie L, de Montjoye L, Rabijns H, Allewaert K, Schrijvers R. A retrospective analysis omalizumab treatment patterns in patients with chronic spontaneous urticaria: a real-world study in Belgium. J Eur Acad Dermatol Venereol 2019; 34:127-134. [PMID: 31099916 PMCID: PMC7003755 DOI: 10.1111/jdv.15684] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 04/23/2019] [Indexed: 01/17/2023]
Abstract
Background Chronic spontaneous urticaria (CSU) is characterized by the repeated occurrence of persistent hives and/or angioedema for ≥6 weeks, without specific external stimuli. H1‐antihistamines have long been the standard of care of CSU, but many patients remain uncontrolled even at 4× the approved dose. Add‐on therapy with omalizumab has proven effective in clinical trials, but little is known about omalizumab treatment in Belgium. Objective To collect real‐world clinical data on omalizumab treatment in adults with CSU in Belgium. Methods This was an observational, retrospective chart review of adults with CSU, who initiated omalizumab treatment between August 2014 and December 2016 (maximum 28 months follow‐up). Results In total, 235 patients were included (median time from symptom onset to diagnosis, 5.4 months; median time from diagnosis to commencing omalizumab, 6.7 months). Treatments used before/after commencing omalizumab did not always adhere to guidelines; many patients (26.4%/11.1%) received first‐generation H1‐antihistamines, while 20.4% used omalizumab monotherapy after initiating treatment. The mean interval between omalizumab administrations was 4.8 (SD 1.7) weeks; 67.8% of patients had ≥1 interval prolongation and/or shortening. Mean baseline 7‐day Urticaria Activity Score (UAS7) was 32.0 (SD 6.05); this improved to 12.6 (SD 11.2) after 1 month of omalizumab. About 67.2% of patients reached UAS7 ≤ 6 (well controlled) during the study. A total of 87 patients stopped omalizumab and never restarted before the end of the observation period; the most prevalent reason was remission of symptoms (49.4% of patients), followed by lack of effect (12.6%), lost to follow‐up (6.9%) and adverse events (3.4%). Headache was the most common adverse event (n = 8/82). No anaphylaxis was reported. Conclusions This study revealed that patients initiated on omalizumab in Belgium had severe CSU at baseline, and showed substantial improvements after 1 month of treatment. Greater adherence to the prescription of guideline‐recommended medications is needed for the treatment of CSU.
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Affiliation(s)
- H Lapeere
- Department of Dermatology, Ghent University Hospital, Gent, Belgium
| | - M Baeck
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - A Stockman
- Department of Dermatology, AZ Delta Campus Rembert Torhout, Torhout, Belgium
| | - V Sabato
- Department of Immunology-Allergology-Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - M Grosber
- Department of Dermatology, Universitair Ziekenhuis Brussel, Brussels, Belgium.,Vrije Universiteit Brussel, Brussels, Belgium
| | - M Moutschen
- Service Infectious Diseases and General Internal Medicine, CHU Liège, Liège, Belgium
| | - J Lambert
- Department of Dermatology University Hospital Antwerp, University of Antwerp, Antwerp, Belgium
| | - L Vandebuerie
- Groepspraktijk Dermatologie Roeselare, Roeselare, Belgium
| | - L de Montjoye
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - H Rabijns
- N.V. Novartis Pharma S.A., Vilvoorde, Belgium
| | - K Allewaert
- N.V. Novartis Pharma S.A., Vilvoorde, Belgium
| | - R Schrijvers
- Laboratory of Clinical Immunology, KU Leuven Department of Microbiology and Immunology, Leuven, Belgium
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5
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Balp MM, Khalil S, Tian H, Gabriel S, Vietri J, Zuberbier T. Burden of chronic urticaria relative to psoriasis in five European countries. J Eur Acad Dermatol Venereol 2017; 32:282-290. [PMID: 28898460 PMCID: PMC6084337 DOI: 10.1111/jdv.14584] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 09/05/2017] [Indexed: 01/22/2023]
Abstract
Background Quantification of burden of chronic spontaneous urticaria (CSU) vs. psoriasis (PsO) is limited. Objective To evaluate the burden associated with CSU vs. PsO of all severities (overall PsO), mild and moderate/severe PsO. Methods This retrospective cross‐sectional analysis compared data from adult patients with chronic urticaria (CU), used as a proxy for CSU, and PsO from the National Health and Wellness Survey in France, Germany, Italy, Spain and the United Kingdom. Outcomes included mental and physical component summary scores (MCS and PCS) calculated from the Short Form (SF)‐36v2 or SF‐12v2, SF‐6D health utility scores, self‐reported psychological complaints (anxiety, depression and sleep difficulties), work productivity and activity impairment, and self‐reported healthcare resource utilization. Bivariate and multivariate analyses for each outcome and comparative groups were conducted. Results This analysis included 769 CU and 7857 PsO (26.9% moderate/severe) patients. Following adjustment for covariates, CU patients showed a greater health‐related quality of life (HRQoL) impairment vs. overall PsO (MCS: −2.4, PCS: −1.6, SF‐6D: −0.03; all P < 0.001). CU patients showed a higher risk of anxiety, depression and sleep difficulties [odds ratio (OR): 1.63, 1.34 and 1.56, respectively; all P < 0.01] and greater healthcare resource use vs. overall PsO. The overall activity impairment was significantly greater in CU patients than in overall PsO patients (P = 0.001), while the impact on work was not significantly different. The results vs. moderate/severe PsO group showed no significant differences on all outcomes. Conclusion Burden of illness in CU is higher than PsO of all severities but similar to that observed in moderate/severe PsO. Both diseases have a similar negative impact on work productivity.
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Affiliation(s)
- M M Balp
- Novartis Pharma AG, Basel, Switzerland
| | - S Khalil
- Novartis Pharma AG, Basel, Switzerland
| | - H Tian
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - S Gabriel
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | | | - T Zuberbier
- Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
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6
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O'Donnell BF. Urticaria: impact on quality of life and economic cost. Immunol Allergy Clin North Am 2014; 34:89-104. [PMID: 24262691 DOI: 10.1016/j.iac.2013.09.011] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Patients with urticaria suffer itch, swellings, fatigue caused by sleep disturbance and the side effects of medication, and disruption of many facets of their lives. Much progress has been made in formally evaluating the degree of quality-of-life (QoL) impairment suffered by patients with urticaria. This review focuses on QoL in chronic urticaria (>6 weeks duration) and examines QoL measures, including the chronic urticaria-quality of life questionnaire (CU-Q2oL). Patients with urticaria have difficulty identifying and coping with their emotions. The psychiatric comorbidity and the financial burden on the patient and society because of chronic urticaria, is also examined.
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Affiliation(s)
- Brigid F O'Donnell
- Department of Dermatology, Children's University Hospital, Temple Street, Dublin 1, Ireland; Department of Dermatology, Mater Misericordiae Hospital, Eccles Street, Dublin 7, Ireland.
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7
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Kibsgaard L, Lefevre AC, Deleuran M, Vestergaard C. A case series study of eighty-five chronic spontaneous urticaria patients referred to a tertiary care center. Ann Dermatol 2014; 26:73-8. [PMID: 24648689 PMCID: PMC3956798 DOI: 10.5021/ad.2014.26.1.73] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 01/29/2013] [Accepted: 01/29/2013] [Indexed: 11/18/2022] Open
Abstract
Background Chronic spontaneous urticaria is a debilitating disease for the patients and often considered by the doctors a very difficult disease to treat. In 2009 the European Academy of Allergy and Clinical Immunology/Global Allergy and Asthma European network/European Dermatology Forum/World Allergy Organization (EAACI/GA2LEN/EDF/WAO) published a revised version of the guidelines for the treatment of urticaria which included an algorithm for the treatment. Objective The objective of this study was to examine the clinical effect and the practical use of the algorithm. Methods The study was performed as a case-series study of all newly referred patients to our urticaria clinic over a period of 18 months. Results Our results show that the single most important and efficient treatment of urticaria patients is up dosing non-sedating antihistamines as recommended by the EAACI/GA2LEN/EDF/WAO guidelines. We did not find any predicting factors for responders to the antihistamine treatment, but about one third of the patients did not respond to the up-dosing of the antihistamines. Conclusion Antihistamines seems to be the most efficient treatment for urticaria; other treatments such as montelukast, azathioprine, and mycophenolate mofetil may also be used, but only in combination with antihistamines and only in the case of an independent antihistamines treatment failure. The EAACI/GA2LEN/EDF/WAO guideline for the treatment of urticaria offers an efficient and simple guidelines for the treatment of urticaria.
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Affiliation(s)
- Line Kibsgaard
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Mette Deleuran
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
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Krause K, Grattan CE, Bindslev-Jensen C, Gattorno M, Kallinich T, Koning HD, Lachmann HJ, Lipsker D, Navarini AA, Simon A, Traidl-Hoffmann C, Maurer M. How not to miss autoinflammatory diseases masquerading as urticaria. Allergy 2012; 67:1465-74. [PMID: 22978406 DOI: 10.1111/all.12030] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2012] [Indexed: 12/13/2022]
Abstract
Urticarial skin reactions are one of the most frequent problems seen by allergists and clinical immunologists in daily practice. The most common reason for recurrent wheals is spontaneous urticaria. There are, however, several less common diseases that present with urticarial rash, such as urticarial vasculitis and autoinflammatory disorders. The latter include cryopyrin-associated periodic syndrome and Schnitzler's syndrome, both rare and disabling conditions mediated by increased interleukin-1 secretion. Apart from the urticarial rash, patients are suffering from a variety of systemic symptoms including recurrent fever attacks, arthralgia or arthritis and fatigue. Autoinflammatory diseases are often associated with a diagnostic delay of many years and do not respond to antihistamines and other treatments of urticaria. Also, the chronic inflammation may lead to long-term complications such as amyloidosis. It is therefore important not to miss these diseases when diagnosing and treating patients with chronic recurrent urticarial rash. Here, we present clinical clues and tips that can help to identify autoinflammatory disorders in patients presenting with chronic urticarial rash and discuss their clinical picture and management.
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Affiliation(s)
| | - C. E. Grattan
- St John's Institute of Dermatology; St Thomas' Hospital; London; UK
| | - C. Bindslev-Jensen
- Department of Dermatology and Allergy Center; Odense University Hospital; Odense; Denmark
| | - M. Gattorno
- UO Pediatria II; G. Gaslini Institute; Genova; Italy
| | | | | | - H. J. Lachmann
- National Amyloidosis Centre; University College London Medical School; London; UK
| | - D. Lipsker
- Faculté de Médecine, Hôpitaux universitaires de Strasbourg; Université de Strasbourg et Clinique Dermatologique; Strasbourg; France
| | - A. A. Navarini
- Department of Dermatology; University Hospital of Zurich; Zurich; Switzerland
| | - A. Simon
- Department of General Internal Medicine; Nijmegen Institute for Infection, Inflammation and Immunology (N4i), Centre for Immunodeficiency and Autoinflammation (NCIA), Radboud University Nijmegen Medical Centre; Nijmegen; The Netherlands
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