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Patient Values and Preferences in Chronic Urticaria Treatment: A Systematic Review
Xiajing Chu1,2, Javeria Mubasher1,2, Lina Chen1,3
1Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
JAMA Dermatology
|October 8, 2025
Summary
Patients with chronic urticaria (CU) prioritize rapid symptom relief and ease of use, but safety becomes paramount when adverse effects increase. These patient values are crucial for improving CU treatment guidelines and research.
Area of Science:
- Dermatology
- Allergy & Immunology
- Patient-Reported Outcomes
Background:
- Patient and caregiver values are essential for effective clinical management.
- Current practice parameters for chronic urticaria (CU) aim to incorporate patient preferences.
- A systematic review on patient and caregiver values for CU management was previously unavailable.
Purpose of the Study:
- To synthesize patient and caregiver values and preferences regarding chronic urticaria (CU) treatment options.
- To inform updates to clinical practice guidelines for CU management.
Main Methods:
- Systematic literature search across multiple databases (MEDLINE, Embase, PsycINFO, CINAHL).
- Independent screening, data extraction, and risk of bias assessment by paired reviewers.
- Qualitative synthesis using thematic and inductive content analysis, with evidence certainty rated using the GRADE-Confidence in the Evidence from Reviews of Qualitative Research approach.
Main Results:
- 18 studies involving 28,497 participants were included.
- Patients highly value rapid (2 days-2 weeks) and long-term symptom improvement, preferring oral/topical treatments over injections or infusions.
- Patients accept minor burdens for symptom relief but prioritize safety and tolerability as adverse effect risks increase.
Conclusions:
- Patients with CU prioritize immediate and sustained relief from hives, itching, and swelling.
- Preference shifts towards avoiding harms and burdens when the risk or severity of adverse effects escalates.
- Findings provide a resource to enhance the trustworthiness of CU recommendations and guide future research and management.
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