TY - JOUR
T1 - Angioedema in Chronic Spontaneous Urticaria Is Underdiagnosed and Has a Substantial Impact
T2 - Analyses From ASSURE-CSU
AU - Sussman, Gordon
AU - Abuzakouk, Mohamed
AU - Bérard, Frédéric
AU - Canonica, Walter
AU - Oude Elberink, Hanneke
AU - Giménez-Arnau, Ana
AU - Grattan, Clive
AU - Hollis, Kelly
AU - Hunter, Shannon
AU - Knulst, André
AU - Lacour, Jean-Philippe
AU - Lynde, Charles
AU - Marsland, Alexander
AU - McBride, Doreen
AU - Maurer, Marcus
AU - Nakonechna, Alla
AU - Ortiz de Frutos, Javier
AU - Reynolds, Maria
AU - Sweeney, Carolyn
AU - Tian, Haijun
AU - Weller, Karsten
AU - Wolin, Daniel
AU - Balp, Maria-Magdalena
N1 - © 2018 The Authors. Allergy Published by John Wiley & Sons Ltd.
PY - 2018/8
Y1 - 2018/8
N2 - Background: ASSURE-CSU revealed differences in physician and patient reporting of angioedema. This post hoc analysis was conducted to evaluate the actual rate of angioedema in the study population and explore differences between patients with and without angioedema. Methods: This international observational study assessed 673 patients with inadequately controlled chronic spontaneous urticaria (CSU). Physicians abstracted angioedema data from medical records, which were compared with patient-reported data. Patients in the Yes-angioedema category had angioedema reported in the medical record and a patient-reported source. For those in the No-angioedema category, angioedema was reported in neither the medical record nor a patient-reported source. Those in the Misaligned category had angioedema reported in only one source. Statistical comparisons between Yes-angioedema and No-angioedema categories were conducted for measures of CSU activity, health-related quality of life (HRQoL), productivity and healthcare resource utilization (HCRU). Regression analyses explored the relationship between Dermatology Life Quality Index (DLQI) score and angioedema, adjusting for important covariates. Results: Among evaluable patients, 259 (40.3%), 173 (26.9%) and 211 (32.8%) were in the Yes-angioedema, No-angioedema and Misaligned category, respectively. CSU activity and impact on HRQoL, productivity, and HCRU was greater for Yes-angioedema patients than No-angioedema patients. After covariate adjustment, mean DLQI score was significantly higher (indicating worse HRQoL) for patients with angioedema versus no angioedema (9.88 vs 7.27, P <.001). The Misaligned category had similar results with Yes-angioedema on all outcomes. Conclusions: Angioedema in CSU seems to be under-reported but has significant negative impacts on HRQoL, daily activities, HCRU and work compared with no angioedema.
AB - Background: ASSURE-CSU revealed differences in physician and patient reporting of angioedema. This post hoc analysis was conducted to evaluate the actual rate of angioedema in the study population and explore differences between patients with and without angioedema. Methods: This international observational study assessed 673 patients with inadequately controlled chronic spontaneous urticaria (CSU). Physicians abstracted angioedema data from medical records, which were compared with patient-reported data. Patients in the Yes-angioedema category had angioedema reported in the medical record and a patient-reported source. For those in the No-angioedema category, angioedema was reported in neither the medical record nor a patient-reported source. Those in the Misaligned category had angioedema reported in only one source. Statistical comparisons between Yes-angioedema and No-angioedema categories were conducted for measures of CSU activity, health-related quality of life (HRQoL), productivity and healthcare resource utilization (HCRU). Regression analyses explored the relationship between Dermatology Life Quality Index (DLQI) score and angioedema, adjusting for important covariates. Results: Among evaluable patients, 259 (40.3%), 173 (26.9%) and 211 (32.8%) were in the Yes-angioedema, No-angioedema and Misaligned category, respectively. CSU activity and impact on HRQoL, productivity, and HCRU was greater for Yes-angioedema patients than No-angioedema patients. After covariate adjustment, mean DLQI score was significantly higher (indicating worse HRQoL) for patients with angioedema versus no angioedema (9.88 vs 7.27, P <.001). The Misaligned category had similar results with Yes-angioedema on all outcomes. Conclusions: Angioedema in CSU seems to be under-reported but has significant negative impacts on HRQoL, daily activities, HCRU and work compared with no angioedema.
KW - angioedema
KW - urticaria
KW - quality of life
KW - economic burden
KW - observational study
UR - http://www.scopus.com/inward/record.url?scp=85049047588&partnerID=8YFLogxK
U2 - 10.1111/all.13430
DO - 10.1111/all.13430
M3 - Article
C2 - 29460968
SN - 0105-4538
VL - 73
SP - 1724
EP - 1734
JO - Allergy
JF - Allergy
IS - 8
ER -