Health-Related Quality of Life in Chronic Urticaria: A Systematic Review and Meta-Analysis

Chronic urticaria (CU), including chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU), significantly affect patients' health-related quality of life (HRQOL). To date, no systematic reviews or meta-analyses have summarized the HRQOL tools used in CU and the magnitude of HRQOL impact in CU.

To determine the HRQOL tools used in CU, the burden of CU regarding HRQOL in adults and children, and whether CU subtypes differentially affect HRQOL.

We searched MEDLINE, Embase, Web of Science, Cochrane, CINAHL, and PsycINFO from inception to August 20, 2023 for original articles including populations of adult or pediatric patients with CU or any of its subtypes in which HRQOL was reported using any quality-of-life instrument. We conducted a series of meta-analyses to pool and compare data on HRQOL outcomes by CU subtype, primarily using the Dermatology Life Quality Index.

We identified 123 publications reporting on 23,508 unique patients with CU and/or its subtypes. The meta-analysis revealed a moderate to large impact of CU and its subtypes on HRQOL. In adults, pooled mean Dermatology Life Quality Index score was 8.9 (95% CI, 7.7-10.1) for CU, 11.0 (95% CI, 9.3-12.7) for CSU, 8.3 (95% CI, 6.8-9.8) for CIndU, and 10.0 (95% CI, 7.7-12.4) for concomitant CSU/CIndU. In children with CSU, mean Children Dermatology Life Quality Index score was 6.9 (95% CI, 1.9-12.0). The analysis revealed high heterogeneity, likely owing to differences in patient population and study design.

Chronic urticaria and its subtypes significantly impair HRQOL. The clinical implication of the differences among CU subtypes needs to be further explored, along with additional research in pediatric populations.