Patient-and physician-reported treatment patterns in chronic spontaneous urticaria (CSU) in the United Kingdom: The Urticaria Voices study
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Authors
Savic S.
ElShanawany T.
Reed J.
Ioannou C.
Rosenberg S.
Raftery T.
Kelman M.
Gkini, M. A.
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2025
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Objectives: British guidelines recommend second-generation H1-antihistamines (H1-AH) as first-line treatment for CSU, with up-dosing up to 4xstandard dose or switching as needed. This analysis from the Urticaria Voices study assessed CSU control and treatment patterns, including up-dosing and switching, in the UK population. Method(s): Urticaria Voices, a multinational, cross-sectional online survey evaluated disease activity (assessed by urticaria control test; UCT) and treatments received in patients with CSU and treatment and disease management in CSU-treating physicians. Physicians and patients were not matched; therefore results are not directly comparable. Data are reported as percentages and/or mean+/-standard deviation. Result(s): Overall, 87 patients (women: n = 51; age: 43.2+/-11.3 years) and 74 CSU-treating physicians (dermatologists, n = 36; allergists n = 38) participated in the study. Approximately 89% (n = 77/87) of patients reported currently using H1-antihistamines and 84% (n = 73/87) reported inadequate control (UCT<12). Three-fourths 989 of patients (74%, n = 57/77) reported that their physician increased the current H1-antihistamine dose (2.1+/-1.5 times), and 83% (n = 64/77) reported H1-antihistamine switching (2.3+/-2.0 times). Overall, 68% (n = 39/57) of patients reported that up-dosing provided no/partial relief, 42% (n = 24/57) experienced drowsiness and 4% (n = 2/57) reported other side effects. Physicians prescribed antihistamines to 77.2% of their patients (H1-AH [52.6%], first-generation H1-antihistamines [24.5%]) and reported that 36.5% of patients on antihistamines had inadequately controlled symptoms. Most physicians (55%; n = 41/74) favoured up-dosing (up to 4x) of the current H1-AH in patients with poorly controlled CSU and switched their patients (3.9+/-10.4 times) to different H1-AH before escalating to biologics. Overall, 51% (n = 38/74) of the physicians reported using UCT in their clinical practice. Conclusion(s): Despite switching and up-dosing majority of patients reported ongoing uncontrolled disease, underscoring the need for more effective treatments to provide sustained relief from CSU. The difference in perceptions of disease control highlights the opportunity for improving communications and treatment among UK physicians and patients. (Funding: Novartis).
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Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology