The comparative burden of chronic spontaneous urticaria, atopic dermatitis and psoriasis in five European countries

Background Skin diseases can have a significant impact on the physical, psychological and social well-being of patients. Quantification of the burden of chronic spontaneous urticaria (CSU) compared to other dermatological conditions is limited. Objectives To evaluate the comparative humanistic and economic burden of CSU, atopic dermatitis (AD), and psoriasis (PSO) in five European countries (EU5). Methods This cross-sectional analysis compared data from adult respondents with a physician diagnosis of CSU, AD and PSO from the 2020 National Health and Wellness Survey in EU5 (France, Germany, Italy, Spain and the United Kingdom). Outcomes included Short Form (SF)-12v2 [mental (MCS) and physical component (PCS) summary scores], SF-6D, EQ-5D, EQ-Visual Analogue Scale (VAS), Dermatology Life Quality Index (DLQI), General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Work Productivity and Activity Impairment (WPAI) and healthcare resource utilization (HRU). Multivariable analyses comparing CSU to AD and PSO, respectively, were conducted for each outcome. Results This analysis included 379 CSU, 788 AD and 2,636 PSO patients. Adjusted MCS and PCS scores were lower among CSU patients than AD (MCS, p = 0.006; PCS, p < 0.001) and PSO (p < 0.001 for all). SF-6D and EQ-5D scores were consistently lower among CSU patients versus AD and PSO (p < 0.001 for all), whereas the EQ VAS was lower in CSU cohort versus PSO cohort (p = 0.003). Higher DLQI scores were reported in the CSU cohort versus AD and PSO (p < 0.001 for both) and the proportion of patients with anxiety and depression, respectively, (GAD-7 and PHQ-9 scores >= 5) was greater among the CSU cohort versus AD and PSO (p < 0.001 for all). Finally, higher HRUs and worse WPAI scores (p < 0.005) were observed in the CSU cohort relative to AD and PSO cohort. Conclusions CSU is associated with significantly worse health-related quality of life, more mental comorbidities, negative impact on patients' daily lives and the ability to work, ultimately leading to higher HRU compared with AD and PSO.