D2.260 - The Burden of Chronic Urticaria

Chronic urticaria (CU) is characterized by the presence of wheals, angioedema, or both, for a period exceeding six weeks. CU imposes a substantial burden on patients due to its prolonged course and distressing symptoms.

This observational study evaluated HRQoL, work productivity, and psychological health in CU patients versus age- and gender-matched healthy controls over four weeks. Using generic and disease-specific PROMs, we assessed multi-dimensional impacts at a specialized tertiary center. Written informed consent was obtained from all participants.

During a one-year period, 850 patients were screened, resulting in the identification of 587 cases of CU. The CU study sample (n=129) consisted of patients aged 18 to 85 years (mean age 49.4 years, SD = 16.3), with a high proportion of females (73%). At Visit 1, the most affected DLQI domain was 'Symptoms and Feelings' (94% of cases), whereas only 42% of patients reported issues with 'Treatment.' A moderate to extremely large disease impact was perceived by 65% of participants; notably, 84% of patients had a UAS7 score > 7, indicating mild to severe disease activity. Furthermore, 96% of these patients achieved the MCID for DLQI scores. Regarding disease control, the MCID for UCT was reached by 80% of the 115 patients with poor baseline control (89% of all patients), while the MCID for AECT was achieved by 88% of the 73 patients (67% of all patients with angioedema) with poor angioedema control. WPAI-GH data showed an average absenteeism of 18% (reported in 33% of cases) and an average presenteeism of 31% in approximately half of the patients (51%). HADS scores were above the cut-off for anxiety in 37% of patients and for depression in 25%, both of which were significantly higher than in the control group (24% and 14%, respectively). Perceived stress levels were higher in 41% of patients compared to 17% of controls. Following therapy optimization, patients showed significant improvement across all eight SF-36 domains (p < 0.001), indicating a highly effective intervention. However, while 89% of patients achieved the MCID on the AE-QoL, 67% reported no improvement in the Fatigue/Mood domain.

These findings highlight that beyond clinical symptom counts, a multidimensional HRQoL assessment is essential for comprehensive CU management, especially regarding its psychological impact. Further investigation in this field is needed.