D1.439 - Urticaria Voices: Physician-reported perspectives of chronic urticaria care and its treatment in China (UV in China)

Chronic urticaria (CU) causes recurrent itchy wheals (hives), angioedema, or both for >6 weeks, classified as chronic spontaneous urticaria (CSU) or chronic inducible urticaria (CIndU) based on trigger factors. China ranks second globally in disability-adjusted life years for urticaria, calling for tailored interventions.  This study investigates Chinese physicians’ perceptions of disease burden and management in CSU and CIndU patients, contributing to the limited real-world evidence on healthcare provider perspectives.

Urticaria Voices China is a descriptive study using 40-minute online surveys targeting both CU patients and treating physicians; this analysis presents data from a nationally representative physician cohort across Chinese provinces.

The cohort included 265 physicians (81% dermatologists, 19% allergists), 70% from tier 3 hospitals. Physicians reported patients consulted a mean of 4 specialists before diagnosis. At first assessment, physicians reported 25% of their patients presented with severe/very severe symptoms. Based on the Urticaria Control Test (UCT), physicians estimated 19% CSU and 18% CIndU patients currently have inadequate disease control. Among inadequate disease-controlled patients, physicians reported significant life domain impacts: 7/10 for mental/emotional and financial burden, and 6/10 for social/intimate relationships (10=extreme negative impact). Additionally, 61% of physicians assessed these inadequately controlled patients as moderately impaired in achieving full life potential. Physicians estimated 44% of CU patients experience sleep issues. While 93% of physicians prioritize complete symptom control, they believe this is achievable in only 59% of patients. Physicians report attempting 3 antihistamine switches before biologic escalation.

Despite reporting ~20% of CU patients with inadequate disease control, physicians recognized substantial burden: most of these patients were assessed as moderately impaired in achieving full life potential. Sleep disturbances were reported across the broader CU population. The gap between treatment goals and perceived achievability, combined with diagnostic delays and multiple treatment failures before escalation highlights that CU impact extends beyond traditional disease metrics, suggesting opportunities for comprehensive assessment and management strategies to address the multidimensional burden of CU in China.