FCAAIA Notes: Chronic urticaria (hives) are those present for 6 weeks or longer. Unfortunately, the vast majority of chronic urticaria are “idiopathic” (CIU). That is, they do not have an identifiable and avoidable trigger. Collectively, these are called chronic spontaneous urticaria (CSU)

CSU is a completely benign condition with exception of its impact on quality of life. Itch probably has the greatest impact on quality of life as it can result in sleep disturbance and loss of productivity at work and school and the unsightly appearance results in absenteeism for work and school.

It is important to not go crazy trying to identify a cause for CSU as most are CIU and no test in the world will tell you how to prevent them. However, we must work hard to control the itch and hopefully the hives as well so you can lead an easy, itch-free, productive life.

(Source:″>, Dec. 9, 2017)

Background: Chronic spontaneous urticaria (CSU) can be debilitating, difficult to treat, and frustrating for patients and physicians. Real‐world evidence for the burden of CSU is limited. The objective of this study was to document disease duration, treatment history, and disease activity, as well as impact on health‐related quality of life (HRQoL) and work among patients with inadequately controlled CSU, and to describe its humanistic, societal, and economic burden.

Methods: This international observational study assessed a cohort of 673 adult patients with CSU whose symptoms persisted for ≥12 months despite treatment. Demographics, disease characteristics, and health care resource use in the previous 12 months were collected from medical records. Patient‐reported data on urticaria and angioedema symptoms, HRQoL, and work productivity and activity impairment were collected from a survey and a diary.

Results: Almost 50% of patients had moderate‐to‐severe disease activity as reported by Urticaria Activity Score. Mean (SD) Dermatology Life Quality Index and Chronic Urticaria Quality of Life Questionnaire scores were 9.1 (6.62) and 33.6 (20.99), respectively. Chronic spontaneous urticaria markedly interfered with sleep and daily activities. Angioedema in the previous 12 months was reported by 66% of enrolled patients and significantly affected HRQoL. More than 20% of patients reported ≥1 hour per week of missed work; productivity impairment was 27%. These effects increased with increasing disease activity. Significant healthcare resources and costs were incurred to treat CSU.

Conclusions: Chronic spontaneous urticaria has considerable humanistic and economic impacts. Patients with greater disease activity and with angioedema experience greater HRQoL impairments.

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