Prevalence, treatment and burden of chronic spontaneous urticaria in five European countries

BACKGROUND: Although chronic spontaneous urticaria (CSU) is a common form of chronic urticaria (CU), its impact on overall disease burden and treatment patterns in real-world settings requires further understanding. OBJECTIVES: To assess prevalence, treatment patterns, disease profile and burden in patients with CSU in five European countries (EU5: France, Germany, Italy, Spain and the United Kingdom [UK]). METHODS: Data were from the 2020 EU5 National Health and Wellness Survey (NHWS). Age- and sex-adjusted prevalence of diagnosed CSU was estimated for the overall EU5 and by country. Sociodemographic, health characteristics, treatment history and dermatology-specific quality of life were described for the CSU cohort. Patient-reported outcomes, including the Short Form 12-item Survey (SF-12v2) mental (MCS), physical component (PCS) summary scores; SF-6D; EQ-5D; General Anxiety Disorder-7 (GAD-7); Patient Health Questionnaire-9 (PHQ-9); Work Productivity and Activity Impairment (WPAI) and healthcare resource use (HRU), were summarized for the CSU cohort, overall and by country and descriptively compared to the full NHWS sample. RESULTS: Of 62,319 respondents, 794 patients were diagnosed with CU. Among these, 519 had CSU. Weighted prevalence of CSU in EU5 was 0.92%. Roughly half of the CSU cohort was treated with prescription and/or over-the-counter medication. Among the CSU cohort, 36.7% of patients experienced a very large to extremely large disease impact (Dermatology Life Quality Index [DLQI] > 10); most had poorly controlled disease (71.6%). Mean MCS, PCS, SF-6D and EQ-5D scores were worse for CSU versus the full NHWS sample. A higher proportion of the CSU cohort, versus the full NHWS sample, had GAD-7 and PHQ-9 scores of ≥5. Mild-severe anxiety, depression and WPAI scores were highest in the UK. HRU was higher in the CSU cohort than in the full NHWS sample. CONCLUSIONS: CSU negatively impacts patients' lives. Yet, many patients remain inadequately treated and uncontrolled. These results highlight a need for comprehensive care approaches to improve patient outcomes.