D3.241 - How Clinical Control of Chronic Urticaria influence in mental health

It is estimated that between 5% to 25% of the adult population suffers from anxiety and/or depression (anxiety/depression). This prevalence is even higher in urticaria patients (30 to 60%), with a great impact on a personal and social level for the patient. Under the hypothesis that this higher incidence of anxiety/depression is secondary to the lack of control of urticaria, the aim of this study was to evaluate the impact of urticaria treatment on these comorbidities.

Participants were recruited from Urticaria Centers of Reference and Excellence (UCARE). We use data from a prospective cohort from four Latin-American countries (Argentina, Colombia, Ecuador, Peru) with CSU patients with aged over 18 years. The follow-up was for at least 6 months. For evaluation of mental health, we use the Goldberg scale, which focuses on anxiety and depression. Urticaria therapy was based on GA2LEN/UCARE guidelines. UAS7 and UCT was used to evaluated urticaria activity and control respectively.

A total of 314 were included. At baseline, a total of 127 (40.4%) patients had anxiety or depression; 93 had both, 20 only anxiety and 14 only depression. After 6-9 months with the use of antihistamines (conventional or higher doses), 181 (57.6%) patients had clinical control (UCT > 12 points) and 99 patients with anxiety/depression had a reduction of 22% from baseline; Anxiety/depression was less frequent in UCT-control (n= 21/181 11.6%) versus UCT-non-control (n= 78/133 58.6%, p < 0.05). In a subgroup of patients who received omalizumab (n = 21), 18 had anxiety/depression; after 4 months with omalizumab 17 had UCT control and only 3 had anxiety/depression. There was a correlation of UCT and UAS7 (r 0.79) but 21% of patients with UAS7 > 6 points had UCT-control and reduction in anxiety/depression frequency

Anxiety/depression frequency is high in chronic urticaria patients but  a control of urticaria means in most of the cases a control of these comorbidities, even in those patients without total control based on urticaria activity score, suggesting that perception of urticaria control is important for Anxiety/depression control