Maurer, MarcusGiménez Arnau, Anna MariaEnsina, Luis FelipeChu, Chia-YuJaumont, XavierTassinari, Paolo2022-02-282022-02-282020Maurer M, Giménez-Arnau A, Ensina LF, Chu CY, Jaumont X, Tassinari P., et al. Chronic urticaria treatment patterns and changes in quality of life: AWARE study 2-year results. World Allergy Organ J. 2020 Sep 12; 13(9): 100460. DOI: 10.1016/j.waojou.2020.1004601939-4551http://hdl.handle.net/10230/52583Background: A Worldwide Antihistamine-Refractory Chronic Urticaria (CU) patient Evaluation (AWARE) is a non-interventional, multicenter study including patients from Europe, Central and Latin America, Asia-Pacific, and the Middle East. AWARE describes real-world evidence for CU, including clinical characteristics, treatment patterns and the impact on quality of life. Methods: Over the 2-year study, therapy changes, angioedema occurrence, and patient-reported outcomes (PROs) were recorded over 9 visits, including dermatology life quality index (DLQI) and 7-day urticaria activity score (UAS7). Data were stratified into subgroups: chronic spontaneous urticaria (CSU), chronic inducible urticaria (CIndU), or CSU + CIndU. Results: Out of 4838 patients analyzed, 9.9% were receiving no treatment for their CU symptoms at baseline, and 20.4% were receiving first-line non-sedating H1-antihistamine at approved doses. The predominant baseline therapy was up-dosed non-sedating H1-antihistamines (25.5%). By Visit 2, omalizumab was the overall most commonly used therapy (29.6%), increasing to 30.1% by the end of the study. Baseline DLQI scores for patients with CSU, CIndU and CSU + CIndU were 8.3, 7.6 and 9.1, respectively; scores decreased over the study for CSU and CSU + CIndU patients, but fluctuated for CIndU patients. Baseline angioedema occurrence was higher in CSU and CSU + CIndU patients, reported in 45.4% and 45.5% of patients, respectively, compared to 17.0% in CIndU patients. By the final visit, angioedema had decreased to 11.9% and 11.2% for CSU and CSU + CIndU, respectively, and 9.6% for CIndU. Conclusion: CU patients are undertreated at baseline; after entering the AWARE study, more patients received appropriate treatment. However, over two thirds are not escalated to third-line treatments.application/pdfeng1939-4551/© 2020 The Authors. Published by Elsevier Inc. on behalf of World Allergy Organization. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)info:eu-repo/semantics/articlehttp://dx.doi.org/10.1016/j.waojou.2020.100460AMACAsia-Pacific and the Middle EastAWAREA Worldwide Antihistamine-Refractory Chronic Urticaria patient EvaluationAngioedemaCIndUChronic inducible urticariaCSUChronic spontaneous urticariaCUChronic urticariaDLQIDermatology life quality indexDermatologyLaCANCentral and Latin AmericaPROPatient-reported outcomeQoLQuality of lifeQuality-of-lifeSDStandard deviationUAS77-day urticaria activity scoreUrticariainfo:eu-repo/semantics/openAccess