Chronic Spontaneous Urticaria (CSU) in Chinese Patients: Real-World Evidence of Disease Control and Treatment Patterns from the Urticaria Voices Study.

introductionChronic spontaneous urticaria (CSU), characterized by recurring itchy wheals (hives) and/or angioedema lasting > 6 weeks without identifiable triggers, affects 1.29% of China's population. China ranks second globally in urticaria disability-adjusted life years (DALYs), thus understanding real-world outcomes is important. We hypothesized that, despite ongoing treatment, a substantial proportion of Chinese patients with CSU experience inadequate disease control and impaired quality of life (QoL), with gaps between their treatment expectations and perceived achievability of optimal control. This study assessed patient-reported burden, treatment patterns, and unmet needs in these patients.

methodsThis was a cross-sectional study using 40-min online surveys. Patients were recruited through online panels. Eligibility included adults ≥ 18 years with physician-confirmed CSU diagnosis, actively treated. Descriptive analysis was stratified by disease control and treatment type.

resultsA total of 400 patients with CSU (mean age 35.09, [SD 7.24] years; 45% female) participated; 2% reported symptom onset < 1 year pre-study, 71% between 1 and 5 years, and 27% > 5 years (mean disease duration 5.31 [SD 4.89]). On the basis of the Urticaria Control Test (UCT), 35% of participants had inadequately controlled disease (UCT < 12), whereas Patient Global Impression of Severity (PGI-S) self-assessment suggested better perceived control (92% mild/no symptoms). Most diagnoses were made by dermatologists (94%); 57% of patients reported no fixed follow‑up schedule. Among inadequately controlled patients, 90% reported sleep disturbance during exacerbations. Most patients (82%) used second-generation antihistamines; one-third used Traditional Chinese Medicine. Complete symptom control was the top treatment goal (mean importance: 8.5/10), yet only 16% believed it achievable (9% of inadequately controlled).

conclusionsOne-third of treated patients with CSU reported inadequate disease control impacting QoL. The disconnect between high priority for complete control and low perceived achievability, alongside irregular follow-ups, highlights limitations in current therapies and care delivery. These findings underscore the need for more effective treatments and structured, patient-centered management pathways to optimize CSU care in China.