Marsland A, Abuzakouk M, Balp M-M, Berard F, Canonica GW, Gimenez-Arnau A, Grattan C, Hollis K, Hunter S, Khalil S, Knulst AC, Lacour L-P, Lynde C, McBride D, Nakonechna A, Ortiz de Frutoz FJ, Oude Elberink JNG, Sussman G, Tian H, Weller K, Maurer M. Chronic spontaneous/idiopathic urticaria patients with moderate activity have similar burden of disease as those with severe activity - results from the ASSURE-CSU study. Presented at the EAACI Congress 2017; June 20, 2017. Helsinki, Finland.

INTRODUCTION: The ASSURE-CSU study aimed to identify and quantify the humanistic and economic burden of chronic spontaneous/idiopathic urticaria (CSU/CIU). Here we present data on economic and humanistic burden among patients with moderate versus severe activity CSU.

METHODS: This non-interventional, multicentre study conducted in Canada, France, Germany, Italy, Netherlands, Spain, and the United Kingdom enrolled patients with CSU aged ≥18 years with disease persisting for ≥12 months and symptomatic despite current treatment. Data came from medical charts, a patient survey and a 7-day diary. Patients completed Dermatological Life Quality Index (DLQI) and Chronic Urticaria Quality of Life (CU-Q2oL) questionnaires at enrolment, UAS questionnaire for 7 days after enrolment and Work Productivity and Activity Impairment- Specific Health Problem (WPAI-SHP) questionnaire on the 8th day. For the current analysis, UAS7 scores were grouped in score bands of 0-15, 16-27, and 28-42 reflecting well-controlled to mild, moderate, and severe disease activity, respectively. All outcomes were evaluated for the 3 disease activity groups; significance tests were performed between moderate vs severe activity patients.

RESULTS: Among a total of 673 patients, there were 182 (27.0%) and 117 (17.4%) patients in moderate [UAS7: 16-27] and severe [UAS7: 28-42] activity groups, respectively. There was no significant difference in age, gender and disease duration between moderate and severe activity patients. Compared with moderate activity patients, severe patients reported significantly greater impairment in quality of life based on higher mean [SD] DLQI (13.5 [6.57] vs 10.6 [6.73]) and CU-Q2oL scores (49.3 [20.87] vs 39.7 [20.76]) (both p<.001). However, moderate activity patients experienced non-significantly different mean [SD] % of absenteeism (7.7 [19.60] vs 9.5 [21.28]), presenteeism (34.5 [29.03] vs 40.4 [27.42]) and overall work impairment (36.3 [29.30] vs 43.6 [28.38]) as severe patients (all p>0.05). The mean [SD] activity impairment was significantly higher in severe activity patients compared with moderate patients (52.3 [27.72] vs 40.5 [28.21]; p<.001).

CONCLUSIONS: Severe activity CSU patients had significantly higher quality of life impairment than moderate patients, but the two groups had comparable impact on their capacity to work. Overall, moderate and severe activity CSU patients tend to have similar high burden of disease.