BACKGROUND: CIU/CSU is defined as the spontaneous appearance of itchy hives, angioedema, or both that recur for 6 weeks. CIU/CSU has a significant impact on patient's health related quality of life (HRQoL). However, there is little information on how angioedema affects patients with CIU/CSU refractory to H1-antihistamines.
OBJECTIVES: ASSURE-CSU, a non-interventional study evaluating the HRQoL, healthcare resource utilization, absence from work and productivity, aims to identify and quantify the humanistic and economic burden of illness in patients with CIU/CSU refractory to H1-antihistamines. Here we describe the presence of angioedema in patients enrolled in the ASSURE-CSU study in Canada and the UK.
METHODS: Patients with CIU/CSU refractory to H1-antihistamines, aged 18 years, with disease persisting 12 months were assessed. These data were collected via a patient survey on history, duration and severity of angioedema. All data were analysed using descriptive statistics.
RESULTS: At the time of the survey, 58/88 (65.9%) Canadian patients experienced angioedema at any time, while 55/88 (62.5%) experienced it in the previous 12 months and 45/88 (51.1%) in the previous 4 weeks. Eyes, lips/mouth, and hands were the most commonly affected areas. An episode lasted 48 hours (hrs) in 9/88 (10.2%), 48 hrs in 6/88 (6.8%) and 24 hrs in 38/88 (43.1%) patients. When patients experienced these episodes, the majority took medication prescribed by their physician (35/88 [39.8%]).Patients rated on a scale of 10 the amount of swelling, itching and pain during a typical episode of angioedema. For these, Canadian patients attributed a mean (SD) score of 7.1 (2.42), 7.9 (2.42) and 5.5 (3.47) respectively. In the UK, 67/79 (84.8%) patients experienced angioedema at any time, while 64/79 (81.0%) experienced it in the previous 12 months and 51/79 (64.6%) in the previous 4 weeks. Eyes, lips/mouth, and hands were the most commonly affected areas. An episode lasted 48 hrs in 12/79 (15.2%), 48 hrs in 7/79 (8.9%) and 24 hrs in 42/79 (53.2%) patients. When patients experienced these episodes, the majority took medication prescribed by their physician (42/79 [53.2%]). For the 3 symptoms, UK patients attributed a mean (SD) score of 7.3 (2.02), 8.0 (2.39) and 6.5 (2.94), respectively.
CONCLUSIONS: This analysis from ASSURE-CSU suggests that angioedema affects a considerable proportion of CIU/CSU patients. More patients in the UK reported experiencing angioedema compared with Canadian patients. However, patients in the UK and Canada identified the extent of swelling, itching and pain felt in a similar manner, suggesting that their personal experience of angioedema is comparable.
