Angioedema in chronic spontaneous urticaria is underdiagnosed and has a substantial impact: Analyses from ASSURE-CSU

G. Sussman, M. Abuzakouk, F. Bérard, Giorgio Walter Canonica, H. Oude Elberink, A. Giménez-Arnau, C. Grattan, K. Hollis, S. Hunter, A. Knulst, J. P. Lacour, C. Lynde, A. Marsland, D. McBride, M. Maurer, A. Nakonechna, J. Ortiz de Frutos, M. Reynolds, C. Sweeney, H. TianK. Weller, D. Wolin, M. M. Balp

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)1724-1734
Number of pages11
JournalAllergy: European Journal of Allergy and Clinical Immunology
Volume73
Issue number8
DOIs
Publication statusPublished - Aug 1 2018

Keywords

  • angioedema
  • economic burden
  • observational study
  • quality of life
  • urticaria

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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    Sussman, G., Abuzakouk, M., Bérard, F., Canonica, G. W., Oude Elberink, H., Giménez-Arnau, A., Grattan, C., Hollis, K., Hunter, S., Knulst, A., Lacour, J. P., Lynde, C., Marsland, A., McBride, D., Maurer, M., Nakonechna, A., Ortiz de Frutos, J., Reynolds, M., Sweeney, C., ... Balp, M. M. (2018). Angioedema in chronic spontaneous urticaria is underdiagnosed and has a substantial impact: Analyses from ASSURE-CSU. Allergy: European Journal of Allergy and Clinical Immunology, 73(8), 1724-1734. https://doi.org/10.1111/all.13430