Patient and physician perspectives on disease burden in chronic spontaneous urticaria: A real-world US survey

Chronic spontaneous urticaria (CSU) is frequently associated with severe disease-related symptoms that negatively affect quality of life, but patients and physicians may differ in their opinion on CSU burden.

To describe the clinical and humanistic burden associated with CSU and level of agreement between patient and physician perceptions of disease burden and treatment satisfaction.

This cross-sectional, survey-based study of US physicians and their adult patients with CSU included data collected in the Adelphi CSU Disease Specific Programme from 2020 to 2021. Overall, 1082 patient record forms completed by 110 physicians (including 40 allergists/immunologists, 50 dermatologists, and 20 primary care physicians) and 474 matched patient-reported questionnaires were included. Paired physician-patient records were used to determine agreement on disease burden and treatment satisfaction.

Patients with CSU often experienced physician-reported itching (66%) and hives (49%) and had a history of angioedema (23%). Although current CSU severity had largely improved since diagnosis, many patients and physicians continued to report moderate/severe current disease symptoms (46% and 30%, respectively). Moderate/severe disease had greater impacts on quality of life, sleep, work impairment, and treatment satisfaction than mild disease. Most patients and physicians agreed on symptom severity (61%-74%), with disagreement largely due to physicians underreporting severity relative to patients. Patient/physician agreement on treatment satisfaction was highest with mild CSU severity (82%), mild hive severity (80%), and omalizumab or other biologic treatment (87%).

Moderate/severe CSU was associated with greater disease burden and lower treatment satisfaction than mild CSU. Physicians more frequently underreported CSU severity compared with their patients.