The global burden of chronic urticaria for the patient and society
M Gonçalo 1, A Gimenéz-Arnau 2, M Al-Ahmad 3, M Ben-Shoshan 4, J A Bernstein 5, L F Ensina 6, D Fomina 7 8, C A Galvàn 9, K Godse 10, C Grattan 11, M Hide 12, C H Katelaris 13, M Khoshkhui 14, E Kocatürk 15, K Kulthanan 16, I Medina 17, I Nasr 18, J Peter 19, P Staubach 20, L Wang 21, K Weller 22, M Maurer 22
Affiliations
Affiliations
- Department of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
- Department of Dermatology, Hospital del Mar, IMIM, Universitat Autònoma, Barcelona, Spain.
- Microbiology Department, Faculty of Medicine, Kuwait University, Kuwait.
- Division of Allergy, Immunology and Dermatology, Department of Pediatrics, Montreal Children's Hospital, McGill University, Montréal, QC, Canada.
- University of Cincinnati College of Medicine, Department of Internal Medicine, Division of Immunology/Allergy Section, Partner Bernstein Allergy Group and Bernstein Clinical Research Center, Cincinnati, OH, USA.
- Alergoalpha/CPAlpha Allergy Clinic and Clinical Research Center and Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo (UNIFESP/EPM), São Paulo, SP, Brazil.
- Moscow City Center of Allergy and Immunology, Clinical City Hospital #52, Department of General Therapy, Pirogov Russian National Research Medical University, Moscow, Russian Federation.
- Department of Allergology and Clinical Immunology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
- Instituto Nacional de Salud del Niño, Centro de Referencia Nacional de Alergia, Asma e Inmunología, Lima, Perú.
- Department of Dermatology, Dr D.Y. Patil School of Medicine, Mumbai, Maharashtra, India.
- St John's Institute of Dermatology, Guy's Hospital, London, UK.
- Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
- Campbelltown Hospital and Western Sydney University, Sydney, NSW, Australia.
- Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Dermatology, Koc University School of Medicine, Istanbul, Turkey.
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
- Centro Medico Vitae, Department of Allergy and Clinical Immunology, Buenos Aires, Argentina.
- Department of Immunology and Allergy, Royal Hospital, Muscat, Oman.
- Division of Allergy and Clinical Immunology, University of Cape Town and Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa.
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany.
- Liangchun Wang - Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Abstract
Chronic urticaria (CU) affects about 1% of the world population of all ages, mostly young and middle-aged women. It usually lasts for several years (> 1 year in 25-75% of patients) and often takes > 1 year before effective management is implemented. It presents as chronic spontaneous urticaria (CSU), chronic inducible urticaria (CIndU) or both in the same person. More than 25% of cases are resistant to H1 -antihistamines, even at higher doses, and third- and fourth-line therapies (omalizumab and ciclosporin) control the disease only in two-thirds of H1 -antihistamine-resistant patients. Here we review the impact of CU on different aspects of patients' quality of life and the burden of this chronic disease for the patient and society. CU may have a strong impact on health-related quality of life (HRQoL), particularly when CSU is associated with angio-oedema and/or CIndU (Dermatology Life Quality Index > 10 in 30% of patients). Comorbidities, such as anxiety and depression, which are present in more than 30% of patients with CSU, compound HRQoL impairment. Severe pruritus and the unpredictable occurrence of weals and angio-oedema are responsible for sleep disorders; sexual dysfunction; limitations on daily life, work and sports activities; interfering with life within the family and in society; and patients' performance at school and work (6% absenteeism and 25% presenteeism). Apart from treatment costs, with annual values between 900 and 2400 purchasing power parity dollars (PPP$) in Europe and the USA, CU is associated with a high consumption of medical resources and other indirect costs, which may reach a total annual cost of PPP$ 15 550.
References
https://pubmed.ncbi.nlm.nih.gov/