Burden of angioedema in patients with chronic spontaneous urticaria in EU5 and US

IF 0.3 4区医学

Revue Francaise d Allergologie Pub Date : 2024-04-01 DOI:10.1016/j.reval.2024.103854

M.M. Balp , K. Krupsky , B.L. Balkaran , S. Gupta , C. Lienhard , D. Patil , R. Kohli , F. Tétart , T. El-Shanawany , J. Reed

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Abstract

Introduction (contexte de la recherche)

Angioedema in chronic spontaneous urticaria (CSU) has a substantial impact on patient's health-related quality of life (HRQoL) and remains underdiagnosed.

Objective

The objective of this study was to assess the burden of angioedema associated with CSU among patients in EU5 (France, Germany, Italy, Spain, and United Kingdom) and the US.

Methods

Data from 2020 EU5 and 2019 US nationally representative surveys of patient-reported outcomes were analyzed. Adult with a physician diagnosis of CSU reported if they experienced angioedema in the past 3 months and were categorized into YES-ANGIO and NO-ANGIO groups. Disease control was assessed using Urticaria Control Test (UCT). Burden associated with angioedema was assessed using several questionnaires including General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9) and Dermatology Life Quality Index (DLQI). Healthcare resource utilization was reported in emergency room (ER) visits and hospitalizations in the past 6 months. Bivariate analyses were conducted.

Results

Among 379 respondents with CSU in EU5 and 371 in the US, YES-ANGIO represented 24.0% and 38.3% of each cohort while NO-ANGIO represented 76.0% in EU5 and 61.7% in the US. Less than 8.0% of the YES-ANGIO patients had well controlled CSU (UCT ≥ 12) compared to > 40.0% of patients with NO-ANGIO (P < 0.001 for EU5 and US). The % of respondents reporting mild/moderate/severe anxiety (GAD-7 ≥ 5) and depression (PHQ-9 ≥ 5) were significantly higher among the YES-ANGIO group compared to NO-ANGIO (EU5: GAD-7: 95.6% vs. 63.2%, and PHQ-9: 94.5% vs. 66.7%; P < 0.001). The mean [SD] DLQI score was significantly higher (worse HRQoL) for YES-ANGIO patients versus NO-ANGIO (EU5: 17.6 [7.4] vs. 4.2 [5.9] P < 0.001). YES-ANGIO patients compared to NO-ANGIO reported a significantly higher ER visits (EU5: 75.8% vs. 22.2% P < 0.001) and hospitalizations (EU5: 72.5% vs. 11.8% P < 0.001) in past six months.

Conclusions

This real-world study shows that angioedema among CSU patients is associated with high humanistic and economic burden, with significantly higher % with anxiety and depression along with significantly higher healthcare resource utilization compared to patients without angioedema.

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欧盟5国和美国慢性自发性荨麻疹患者的血管性水肿负担

引言（研究背景）慢性自发性荨麻疹（CSU）中的血管性水肿对患者与健康相关的生活质量（HRQoL）有很大影响，但仍未得到充分诊断。研究目的：本研究旨在评估欧盟5国（法国、德国、意大利、西班牙和英国）和美国患者中与CSU相关的血管性水肿的负担。经医生诊断为 CSU 的成人报告其在过去 3 个月中是否出现过血管性水肿，并将其分为 YES-ANGIO 组和 NO-ANGIO 组。使用荨麻疹控制测试（UCT）评估疾病控制情况。与血管性水肿相关的负担通过几种问卷进行评估，包括一般焦虑症-7（GAD-7）、患者健康问卷-9（PHQ-9）和皮肤科生活质量指数（DLQI）。过去 6 个月的急诊室就诊和住院情况报告了医疗资源使用情况。结果在欧盟5国的379名CSU受访者和美国的371名CSU受访者中，YES-AGIO人群分别占24.0%和38.3%，而NO-AGIO人群在欧盟5国占76.0%，在美国占61.7%。不到 8.0% 的 YES-ANGIO 患者的 CSU 控制良好（UCT ≥ 12），而 40.0% 的 NO-ANGIO 患者的 CSU 控制良好（欧盟 5 国和美国的 P 均为 0.001）。报告轻度/中度/重度焦虑（GAD-7 ≥ 5）和抑郁（PHQ-9 ≥ 5）的受访者百分比，YES-AGIO 组明显高于 NO-ANGIO 组（欧盟 5 国：GAD-7：95.6% 对 63.2%，PHQ-9：94.5% 对 66.7%；P < 0.001）。与 NO-ANGIO 相比，YES-AGIO 患者的 DLQI 平均 [SD] 分数明显更高（HRQoL 更差）（EU5：17.6 [7.4] vs. 4.2 [5.9] P < 0.001）。结论这项真实世界的研究表明，与无血管性水肿的患者相比，CSU 患者中的血管性水肿与较高的人文和经济负担有关，焦虑和抑郁的比例明显较高，医疗资源利用率也明显较高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revue Francaise d Allergologie Medicine-Immunology and Allergy

自引率

33.30%

发文量

349

期刊介绍： La Revue Française d''Allergologie : un véritable forum pour faire connaître des travaux originaux et permettre la diffusion de l''information auprès de toutes les spécialités concernées par les pathologies allergiques. La Revue Française d''Allergologie (8 numéros par an) est au carrefour de nombreuses spécialités - dermatologie, pédiatrie, ORL, pneumologie, ophtalmologie, médecine interne - qui, toutes, ont à traiter des maladies allergiques. Les symptômes des allergies fondés sur des mécanismes communs sont le plus souvent associés et se succèdent chez un même patient. En forte progression depuis 20 ans, les maladies allergiques sont dans l''attente de perfectionnements et d''avancées thérapeutiques qui permettront aux nombreux patients qui en sont atteints de mieux vivre avec leurs allergies. La Revue Française d''Allergologie se veut donc un véritable forum de discussions et d''échanges entre tous les spécialistes confrontés aux pathologies