D2.76 - Disease Control, Activity and Quality of Life in Chronic Spontaneous Urticaria A Cross-Sectional Study from Kazakhstan

Chronic spontaneous urticaria (CSU) significantly impairs patients' quality of life (QoL) due to its unpredictable clinical course, sleep disturbances, and associated psychosocial burden. Despite its global prevalence, CSU remains under-researched in Central Asia, particularly regarding real-world clinical data from Kazakhstan. This study aimed to evaluate the levels of disease activity, control, and QoL among CSU patients in Kazakhstan and to identify clinical predictors associated with severe disease activity to support better management strategies.

We conducted a comprehensive cross-sectional study involving 350 adult patients diagnosed with CSU at the Republican Allergy Center in Almaty between December 2024 and June 2025.. Patients were classified by phenotype, including co-existing chronic inducible urticaria (CIndU) and angioedema. Disease activity, control, and QoL were evaluated using the Urticaria Activity Score over 7 days (UAS7), Urticaria Control Test (UCT), and Dermatology Life Quality Index (DLQI). Multivariable logistic regression identified predictors of severe disease.

Among 350 patients (mean age 43.5 years; 78% female), 53.7% had associated phenotypes beyond CSU alone. Severe urticaria (UAS7 ≥ 28) affected 30% of patients. Suboptimal disease control (UCT ≤ 11) was reported by 30%, and 30% experienced strong or very strong QoL impairment (DLQI > 10). Older disease onset (≥60 years; OR = 1.98; 95% CI: 1.02–3.81) and nighttime symptoms (OR = 1.67; 95% CI: 1.02–2.73) were independently associated with severe disease. A strong inverse correlation was observed between UAS7 and UCT (ρ = -0.71), while UAS7 positively correlated with DLQI (ρ = 0.66).

CSU imposes a considerable clinical and psychosocial burden in Kazakhstan, with one-third of patients experiencing severe symptoms and impaired quality of life despite treatment. Older age at disease onset and nighttime symptoms may serve as practical indicators of severe disease. Routine use of validated assessment tools may improve monitoring and support optimized management strategies in resource-constrained healthcare settings.