Disease-specific impairment of the quality of life in adult patients with chronic spontaneous urticaria

Abstract

Background/AimsChronic urticaria (CU) is a common skin disorder characterized by wheals and pruritus lasting more than 6 weeks. Due to its long duration and changeable symptoms, the quality of life (QOL) of patients with CU can be impaired substantially. We evaluated the CU-QOL, a previously validated CU-specific QOL measure, and investigated factors influencing QOL in chronic spontaneous urticaria (CSU) patients.MethodsA hospital-based cross-sectional study was performed on 390 adult patients diagnosed with CSU from March 2009 to December 2012 at the Allergy and Clinical Immunology Clinic at Ajou University Hospital. The CU-QOL questionnaire, urticaria activity score (UAS), combined angioedema, and serum total immunoglobulin E (IgE) levels were investigated.ResultsThe average CU-QOL score obtained from the questionnaire was 70.6 (of 100 points). The CU-QOL scores correlated significantly with the UAS, particularly with the 15-point UAS (UAS-15; coefficient –0.532, p < 0.01) rather than the 6-point UAS (–0.502, p < 0.01). The patients presenting with angioedema and urticaria had poorer scores in the urticaria symptom domain than those with urticaria alone (37.4 vs. 46.9, p = 0.004). Log-transformed serum total IgE levels correlated significantly with CU-QOL (–0.131, p < 0.05). Multivariate regression models indicated that severe CU (UAS-15 score ≥ 13), log (total IgE), and the presence of angioedema were significant predictors of impaired CU-QOL (< 85 points).ConclusionsCU has a substantial negative impact on QOL. The assessment of UAS-15, total IgE, and the presence of angioedema can be useful to predict QOL of the patients with CSU.

Effectiveness of omalizumab in chronic spontaneous urticaria assessed with patient‐reported outcomes: a prospective study

“…14 The reasons for a poorer response among these patients could be more severe disease activity at onset or long-standing refractory disease. Furthermore, presence of angio-oedema is seen as a significant predictor of impaired quality of life in CSU patients 34 and low response to omalizumab treatment. 14 In our study, almost 30% of the patients reported presence of angiooedema, which is a bit less compared to previous studies where almost 40-55% of the patients reported angiooedema; 2-4,7,8 however, it was not possible to predict a significant difference in clinical response to omalizumab between patients with or without angio-oedema.…”

Antihistamine‐resistant chronic spontaneous urticaria: 1‐year data from the AWARE study

“…CSU can result in work productivity loss and absenteeism, interference with sleep and daily activities, and high levels of anxiety and psychological distress . Moreover, CU‐associated angioedema can cause significant QoL impairment, owing to its unpredictable development and/or functional impairment, which instills fears of suffocation …”

Omalizumab rapidly improves angioedema‐related quality of life in adult patients with chronic spontaneous urticaria: X‐ACT study data

“…Furthermore, recent data from the observational AWARE study indicate that 46.1% of German CSU patients, who remained symptomatic despite treatment with at least the approved dose of H 1 ‐antihistamines, had both, wheals and angioedema, while 2.9% exclusively had angioedema . Angioedema is a major driver of quality‐of‐life (QoL) impairment in patients with CSU . Owing to the unpredictable development of disfigurement and/or functional impairment, angioedema episodes can have a significant impact on daily activities and social interactions in CSU patients .…”