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. 2018 Feb;32(2):282-290.
doi: 10.1111/jdv.14584. Epub 2017 Oct 12.

Burden of chronic urticaria relative to psoriasis in five European countries

M M Balp  1 , S Khalil  1 , H Tian  2 , S Gabriel  2 , J Vietri  3 , T Zuberbier  4
Affiliations

Burden of chronic urticaria relative to psoriasis in five European countries

M M Balp et al. J Eur Acad Dermatol Venereol. 2018 Feb.

Abstract

Background: Quantification of burden of chronic spontaneous urticaria (CSU) vs. psoriasis (PsO) is limited.

Objective: To evaluate the burden associated with CSU vs. PsO of all severities (overall PsO), mild and moderate/severe PsO.

Methods: This retrospective cross-sectional analysis compared data from adult patients with chronic urticaria (CU), used as a proxy for CSU, and PsO from the National Health and Wellness Survey in France, Germany, Italy, Spain and the United Kingdom. Outcomes included mental and physical component summary scores (MCS and PCS) calculated from the Short Form (SF)-36v2 or SF-12v2, SF-6D health utility scores, self-reported psychological complaints (anxiety, depression and sleep difficulties), work productivity and activity impairment, and self-reported healthcare resource utilization. Bivariate and multivariate analyses for each outcome and comparative groups were conducted.

Results: This analysis included 769 CU and 7857 PsO (26.9% moderate/severe) patients. Following adjustment for covariates, CU patients showed a greater health-related quality of life (HRQoL) impairment vs. overall PsO (MCS: -2.4, PCS: -1.6, SF-6D: -0.03; all P < 0.001). CU patients showed a higher risk of anxiety, depression and sleep difficulties [odds ratio (OR): 1.63, 1.34 and 1.56, respectively; all P < 0.01] and greater healthcare resource use vs. overall PsO. The overall activity impairment was significantly greater in CU patients than in overall PsO patients (P = 0.001), while the impact on work was not significantly different. The results vs. moderate/severe PsO group showed no significant differences on all outcomes.

Conclusion: Burden of illness in CU is higher than PsO of all severities but similar to that observed in moderate/severe PsO. Both diseases have a similar negative impact on work productivity.

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Figures

Figure 1
Figure 1
Mean physical (PCS) and mental (MCS) component summary scores in CU patients relative to PsO patients (overall, mild and moderate/severe). (a) Bivariate analysis. **P < 0.05; (b) Multivariate analysis, *P < 0.05; **P < 0.001; CU, chronic urticaria; MCS, Mental Component Summary score; PCS, Physical Component Summary score; PsO, psoriasis.
Figure 2
Figure 2
Self‐reported psychological complaints in CU patients relative to PsO patients (overall, mild and moderate/severe): bivariate analysis. **P < 0.001; CU, chronic urticaria; PsO, psoriasis.
Figure 3
Figure 3
Work Productivity and Activity Impairment (WPAI) scores in CU patients relative to PsO patients (overall, mild and moderate/severe): bivariate analysis. **P < 0.05; *P < 0.001; CU, chronic urticaria; PsO, psoriasis.
Figure 4
Figure 4
Alternative HCP visits in CU patients relative to PsO patients (overall, mild and moderate/severe): bivariate analysis. **P < 0.05; *P < 0.001; CU, chronic urticaria; HCP, healthcare practitioner; PsO, psoriasis.
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