Urticaria Voices

INTRODUCTIONChronic 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 identifiable trigger presence. China ranks second globally in disability-adjusted life years for urticaria, calling for tailored interventions. This study investigated perceptions of Chinese dermatologists and allergists regarding the disease burden and management in patients with CU.

METHODSA cross-sectional online survey (40 min) was conducted among 265 specialists (81% dermatologists, 19% allergists) across China. Eligible physicians had autonomous prescribing authority for all CU treatments including biologics, and active CSU/CIndU caseloads. Participants recalled patient characteristics, burden across life domains, and treatment patterns.

RESULTSPhysicians reported that patients consulted a mean of four specialists before diagnosis. At initial assessment, 25% presented with severe/very severe symptoms. Currently, 19% of patients with CSU and 18% with CIndU have inadequately controlled disease (urticaria control test [UCT] < 12). Among these patients, physicians reported substantial burden: 7/10 for mental/emotional and financial domains and 6/10 for social relationships (10 = extreme negative impact). Overall, 61% were assessed as moderately impaired in achieving full life potential. Sleep disturbances affected 44% of all patients with CU. While 93% of physicians prioritize complete symptom control, they believe this is achievable in 59% of patients. Physicians attempt a mean of three antihistamine switches before biologic escalation.

CONCLUSIONSDespite recalling ~20% inadequate disease control rates, physicians recognize substantial burden with most patients impaired in achieving life potential. The gap between treatment goals and perceived achievability, combined with diagnostic delays and conservative escalation patterns, highlights opportunities for comprehensive CU management in China.

Abstract from PubMed