Clinical burden, treatment, and disease control in patients with chronic spontaneous urticaria: Real-world evidence.

Background: Chronic spontaneous urticaria (CSU) is an unpredictable inflammatory skin condition with substantial clinical burden that affects 0.23-0.78% of the United States population.

Objective: To describe the incidence and prevalence of patients with a record of CSU diagnosis, treatment patterns, disease control, and clinical and economic burden in a United States (US) cohort of patients with CSU.

Methods: Adults with a record of CSU diagnosis within the US HealthVerity claims database were eligible. Age- and sex-adjusted prevalence/incidence rates were calculated for January 2017 to December 2022. Clinical characteristics were described during the 1 year prior to CSU diagnosis (baseline) and the time after (follow-up). Proxy events representing uncontrolled CSU (any record of prescriptions for corticosteroids, biologics, or immunosuppressants [excluding all antihistamines and over-the-counter medication] or any CSU-related inpatient admissions or emergency room or urgent care visits) were used to identify patients with uncontrolled CSU. Health care resource utilization (HCRU) and health care costs were described.

Results: Overall, 200,298 patients were followed-up for a median of 2.3 years after diagnosis. Estimated cumulative prevalence of diagnosed CSU was 0.57% (women: 0.80%; men: 0.32%). The average annual incidence rate was 0.08%. Corticosteroids were the most prescribed treatment during follow-up among the 166,195 patients prescribed ≥1 treatment (94.3%). Proxy events were observed in 59.1% of patients. HCRU and health care costs increased from baseline in patients with uncontrolled CSU during follow-up.

Conclusion: Of patients with CSU who were prescribed treatment, >50% experienced uncontrolled CSU, which was associated with increased HCRU and health care costs.