A recent study involving 386 patients with chronic urticaria found that individuals with chronic spontaneous urticaria experienced significantly worse quality of life, higher outpatient medical costs, and stronger awareness of biologics compared with those with chronic induced urticaria.
The study, conducted across three hospitals in China between November 2024 and April 2025, included 228 patients with chronic spontaneous urticaria (CSU) and 158 with chronic induced urticaria (CIndU). Participant ages ranged from 5 to 81 years(mean age 33.3 years), with females accounting for 60.4% of the sample. CSU was more prevalent, affecting 59.1% of participants.
Quality of life was assessed using the Dermatology Life Quality Index (DLQI). Patients with CSU had higher DLQI scores than those with CIndU (8.3 ± 6.0 vs 6.2 ± 4.2; P < .001), indicating greater impairment. Significant differences were found in five of six DLQI dimensions, including symptom perception, daily life, entertainment, interpersonal interaction, and treatment impact.
Regression analysis identified urticaria type, comorbidities, and Urticaria Control Test (UCT) scores as significant predictors of quality of life (P < .05). Patients with CSU, comorbid conditions, and UCT scores below 12 reported poorer outcomes.
Patients with CSU also incurred greater economic burden. Outpatient costs exceeding 5000 yuan were reported by 10.6% of patients with CSU, compared with 2.5% of those with CIndU (P = .027). Additionally, 11.4% of all patients reported that treatment costs exceeded 10% of household income. CSU was also associated with more missed workdays (9.8 ± 6.9 vs. 6.4 ± 5.6; P < .001) and a higher likelihood of requiring chaperones during medical visits.
Logistic regression analysis identified CSU diagnosis, resident medical insurance, comorbidities, and disease duration greater than 12 weeks as independent predictors of higher outpatient costs (P < .05).
Awareness of biologics varied between groups. Among 281 patients not using biologics, 74.0% reported limited understanding, with 50.5% citing high cost as the main barrier. Only 17.8% were willing to consider long-term biologic use.
Among 105 biologic users, patients with CSU demonstrated higher knowledge scores than CIndU patients (P < .05). Although 90.5% understood how to manage adverse reactions , fewer understood the risk of relapse (40.0%), COVID-19 vaccination implications (29.5%), or the need for routine physical examinations (26.7%).
Multiple linear regression showed that younger age, higher education level, and CSU diagnosis were associated with increased biologic knowledge (P < .05).
This study “highlights significant differences between CSU and CIndU in terms of quality of life, economic burden, and knowledge about biological agents. These findings underscore the need for tailored treatment approaches and patient management strategies,” wrote Shixi Ma, Department of Clinical Medicine, Xuzhou Medical University. Patients with CSU had higher DLQI score compared to CIndU patients, indicating a greater impact on quality of life.
These findings highlight differences in disease burden and awareness between urticaria subtypes, suggesting the need for tailored patient education and treatment strategies.
The authors reported no conflicts of interest.