A Specialized Therapeutic Approach to Chronic Urticaria Patient's Refractory to H1-Antihistamines Improves the Burden of the Disease. The Spanish AWARE Experience

Objective: AWARE study assesses disease activity, patient's quality of life (QoL) and treatment patterns in chronic urticaria (CU) patient's refractory to H1-antihistamines (H1-AH) in clinical practice during the first year of the study.

Methods: Observational, prospective (24 months), international, multicenter study. Patients ≥18 years with H1-AH-refractory CU diagnosis (>2 months). At each visit, patients completed questionnaires to assess disease burden (Urticaria Control Test [UCT]), disease activity (7 day-Urticaria Activity Score [UAS7]), QoL (Dermatology Life Quality index [DLQI], Chronic Urticaria Quality of Life Questionnaire [CU-Q2oL], Angioedema Quality of Life [AE-QoL]). We present Spanish data.

Results: 270 evaluable patients included (73.3% female, mean age [SD] 48.9 [14.7] years). At baseline, 89.3% were prescribed a CU treatment. After 1-year, first/second line treatments tended to decrease and third line to increase. 47.0% patients experienced angioedema at baseline, being 11.8% at 1-year. Mean (SD) AE-QoL went from 45.2 (28.7) to 24.0 (25.8). Mean (SD) UCT went from 7.0 (4.5) to 12.1 (4.1). According to UAS7, 38.2% patients reported absence of wheals and itch in the last 7 days at 1-year versus 8.3% at baseline. Mean (SD) DLQI went from 8.0 (7.4) to 2.8 (4.6). At 1-year visit, the percentage of patients reporting high/very high QoL impact went from 29.9% to 9.6%.

Conclusions: Spanish H1-AH-refractory CU patients present a lack of symptomatology control with an important impact in their QoL. Continuous follow-up of chronic spontaneous urticaria patients and third line therapies have shown a tendency to reduce the burden of the disease and to improve patients' QoL.

CITA DEL ARTÍCULO  J Investig Allergol Clin Immunol. 2022 Jun 20;32(3):191-199. doi: 10.18176/jiaci.0661. Epub 2020 Dec 22.