Impact of chronic urticaria on quality of life and work in Japan: Results of a real‐world study

Abstract

Little attention has been given to the burden of chronic urticaria (CU) in Japan compared with other skin diseases, such as atopic dermatitis (AD) and psoriasis. The primary objective of the RELEASE study was to evaluate the real‐life quality‐of‐life impairment in CU patients in Japan. Data were collected from 1443 urticaria, 1668 AD and 435 psoriatic patients; 552 urticaria patients who presented urticaria symptoms for over 6 weeks were defined as CU. The mean Dermatology Life Quality Index (DLQI) total score was 4.8, 6.1 and 4.8 in CU, AD and psoriatic patients, respectively. Disease control of urticaria evaluated by the Urticaria Control Test (UCT) and DLQI exhibited a strong correlation with a Spearman's rank correlation coefficient of −0.7158. CU and AD patients had relatively higher scores in all Work Productivity and Activity Impairment – General Health subscales except for absenteeism. At the time of the survey, approximately 64% of CU patients reported UCT scores of <12 and demonstrated higher work productivity loss and activity impairment versus patients with UCT scores of ≥12. Patients with lower UCT scores also displayed a higher percentage of dissatisfaction with their health state and the treatment they received. Approximately 85% of patients with CU had visited dermatology clinics, and less than 20% had visited hospital, indicating existence of a highly burdened population outside specialized centers. These results highlight the unmet medical needs of CU patients, suggesting the need to increase awareness of CU burden among both physicians and patients and to pursue improved real‐life patient care.

Perspectives on Living with Chronic Spontaneous Urticaria: From Onset through Diagnosis and Disease Management in the US

“…Similar to our study, the Italian study found patients experienced a range of negative emotions, with frustration common in the period leading to diagnosis and a high proportion of patients reporting impairment to QoL (11). Other studies have also reported patient dissatisfaction with their treatment and physicians (5,8). However, patients whose physicians had discussed the emotional impact of CSU were significantly (p < 0.001) more satisfied with treatment and more trusting of their physician.…”

“…The extent to which patients' quality of life (QoL) can be affected by CSU has been demonstrated in numerous studies (1,2,(4)(5)(6)(7)(8) and goes beyond effects on skin (e.g. itching), with many patients reporting fatigue, pain, and sleep disturbances.…”

“…Patients also experience a substantial psychological burden; many develop anxiety and depression after diagnosis, which significantly impacts their QoL (6,7,9,10). Patients also report dissatisfaction with their treatment and their relationship with their physician (5,8,11). Highlighting the value of the physician acknowledging the emotional element of CSU, one study found that patients whose physician had discussed the emotional impact of the disease with them were significantly more satisfied with their treatment and also more trusting of their physician (8).…”

A single reaction-diffusion equation for the multifarious eruptions of urticaria

“…Recent development of biologics, such as omalizumab, humanized monoclonal antibody against IgE, have largely improved its treatment [38,39]. However, many patients still do not benefit from or tolerate such therapies, and the molecular mechanism of wheal formation in urticaria is poorly understood [1,2,5]. It is largely due to a lack of proper experimental, small animal models for urticaria.…”

“…Urticaria is classified as the chronic type when it lasts for 6 weeks or longer, and is further divided into chronic spontaneous urticaria (CSU) and chronic inducible urticaria [3,4]. Chronic urticaria has a significant impact on quality-of-life due to regular recurrence of disfiguring eruptions with itching, and unknown etiology [1,5]. Moreover, urticaria may be a symptom of anaphylaxis that seriously affects the patient's life.…”