The Burden of Chronic Spontaneous Urticaria: A Narrative Literature Review

Chronic spontaneous urticaria (CSU) accounts for most cases of chronic urticaria; however, the prevalence and disease burden are not well characterized.

A narrative literature review based on structured and targeted searches of the literature and iterative hand searches based on expert knowledge was conducted to assess the epidemiology and humanistic burden of CSU. Targeted searches were conducted in EMBASE (including conference abstracts), MEDLINE, and health technology agencies using a combination of terms related to "chronic spontaneous urticaria" between January 1, 2010, and June 13, 2023.

The searches retrieved a total of 62 articles. CSU prevalence was reported at 0.08%-2% across Asia, Europe/UK, North America, and South America. Risk factors reported for CSU included female sex, older age, and autoimmune conditions. Itch was the primary and most troublesome symptom. CSU has a significant burden on physical and mental health-related quality of life (HRQoL). Healthcare resource utilization (HCRU) in patients with CSU was driven by outpatient physician office and emergency department visits. Poorly controlled CSU led to greater impact on HRQoL and HCRU. 24 articles reported on available treatment approaches and/or emerging therapies that target the underlying pathophysiology of CSU. Significant evidence gaps were identified, including the need for epidemiological data from a wider range of geographic regions and economic and cost-of-illness analyses. This narrative literature review demonstrates that CSU is associated with a significant burden of symptoms, reduced HRQoL, and HCRU. Early and appropriate diagnosis and new, effective treatment options are needed for patients with CSU.