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Differences in chronic spontaneous urticaria between Europe and Central/South America: results of the multi-center real world AWARE study

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dc.contributor.author Maurer, Marcus
dc.contributor.author Houghton, Katherine
dc.contributor.author Costa, Claudia
dc.contributor.author Dabove, F.
dc.contributor.author Ensina, Luis Felipe
dc.contributor.author Giménez Arnau, Anna Maria
dc.contributor.author Guillet, Gérard
dc.contributor.author Konstantinou, George N.
dc.contributor.author Labrador-Horrillo, Moises
dc.contributor.author Lapeere, Hilde
dc.contributor.author Meshkova, Raisa Y.
dc.contributor.author Pastorello, Elide Anna
dc.contributor.author Velásquez-Lopera, Margarita
dc.contributor.author Tamayo Quijano, L.M.
dc.contributor.author Vestergaard, Christian
dc.contributor.author Chapman-Rothe, Nadine
dc.date.accessioned 2019-07-22T07:57:00Z
dc.date.available 2019-07-22T07:57:00Z
dc.date.issued 2018
dc.identifier.citation Maurer M, Houghton K, Costa C, Dabove F, Ensina LF, Giménez-Arnau A. et al. Differences in chronic spontaneous urticaria between Europe and Central/South America: results of the multi-center real world AWARE study. World Allergy Organ J. 2018 Nov 16;11(1):32. DOI: 10.1186/s40413-018-0216-1
dc.identifier.issn 1939-4551
dc.identifier.uri http://hdl.handle.net/10230/42123
dc.description.abstract BACKGROUND: Global chronic urticaria (CU) disease experience and management is not well documented. This study descriptively compares these aspects among CU patients residing in Europe (EU) and Central and South America (C/SA). METHODS: AWARE (A World-wide Antihistamine-Refractory chronic urticaria patient Evaluation) is a global prospective, non-interventional study of CU in the real-world setting. Patients were ≥ 18 years with a diagnosis of H1-antihistamine-refractory CU for > 2 months. Differences between the EU and C/SA regions in demographic and clinical characteristics, quality of life (QoL), work and activity impairment, pharmacological treatment, and healthcare resource use were examined. RESULTS: In total, 4224 patients were included in the analysis (C/SA 492; EU 3732). Rates of untreated patients were greater in the C/SA region (45.1% vs. 31.9%; P < 0.005) and escalation to third-line therapy was rare in both regions. Differences in disease experience emerged, with C/SA patients more commonly experiencing angioedema (C/SA 50.8% vs. EU 46.1%; P = 0.03) or comorbid chronic inducible urticaria (C/SA 30% vs. EU 22%; P < 0.001). Correspondingly, rates of uncontrolled urticaria were higher among C/SA patients (82.8% vs. 77.5%; P = 0.017) and patients in the C/SA region showed significantly greater work and activity impairment (absenteeism: 10.4 ± 19.7 vs. 6.7 ± 19.0, P = 0.004; presenteeism: 30.3 ± 31.9 vs. 24.4 ± 25.8, P = 0.001; work productivity loss: 33.9 ± 33.9 vs. 26.5 ± 27.5, P < 0.001; activity impairment: 37.7 ± 34.7 vs. 32.7 ± 30.1, P = 0.001). However, QoL impairment was greater in the EU region (Dermatology Life Quality Index: C/SA 6.5 ± 5.9 vs. EU 8.3 ± 7.0; P < 0.001). There was a significant difference in use of healthcare resources, including emergency services (39.6% vs. 29.3%; P < 0.001), hospitalization (7.7% vs 21.9%; P < 0.001) general practitioners (31.7% vs 57.3%; P < 0.001), and additional allergists or dermatologists (50.6% vs. 47.3%, P < 0.001), among patients in the C/SA and EU region, respectively. In both regions, patients with a primary diagnosis of CU with angioedema had significantly greater impairment in work and non-work activities and healthcare resource utilization compared to those without angioedema. CONCLUSIONS: This study revealed that CU is a heterogeneous condition with differences in healthcare utilization and outcomes between EU and C/SA. However, overall there is a high unmet need of H1-antihistamine-refractory CU patients, which is associated with high use of healthcare resources, and has a large negative effect on QoL and work productivity.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Elsevier
dc.rights © The Author(s). 2018. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, andreproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link tothe Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.title Differences in chronic spontaneous urticaria between Europe and Central/South America: results of the multi-center real world AWARE study
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1186/s40413-018-0216-1
dc.subject.keyword Angioedema
dc.subject.keyword Chronic spontaneous urticaria
dc.subject.keyword Quality of life
dc.subject.keyword Urticaria
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion


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