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1دورية أكاديمية
المؤلفون: Maurer, Marcus, Augustin, Matthias, Bauer, Sabine, Ekanayake‐Bohlig, Swarna, Kircher, Philipp, Knöll, Anja, Kramps, Thomas, Kurzen, Hjalmar, Laemmel, Sonja, Novak, Natalija, Oppel, Eva, Pirouzmandi, Lal, Rebhan, Michael, Reimnitz, Ulrich, Richter‐Huhn, Grit, Schwarz, Beate, Schwichtenberg, Uwe, Staubach, Petra, Termeer, Christian, Thielen, Antje, Varga, Katarina, von Bubnoff, Dagmar, Zink, Alexander, Gmeiner, Benjamin, Nathan, Petra
المساهمون: Novartis Pharma
المصدر: Journal of the European Academy of Dermatology and Venereology ; ISSN 0926-9959 1468-3083
الوصف: Background Chronic spontaneous urticaria (CSU) is both physically and emotionally stressful, and guideline recommendations are often not optimally implemented in clinical practice. The objective of this study was to provide an overview on the patient journey in CSU and to develop a mathematical model based on solid data. Methods The journey of CSU patients in Germany was traced through literature review and expert meetings that included medical experts, pharmacists and representatives of patient organizations. The current situation's main challenges in the patient journey (education, collaboration and disease management) were discussed in depth. Then, a probabilistic model was developed in a co‐creation approach to simulate the impact of three potential improvement strategies: (1) patient education campaign, (2) medical professional education programme and (3) implementation of a disease management programme (DMP). Results Chronic spontaneous urticaria patients are severely burdened by delays in diagnosis and optimal medical care. Our simulation indicates that in Germany, it takes on average of 3.8 years for patients to achieve disease control in Germany. Modelling all three optimization strategies resulted in a reduction to 2.5 years until CSU symptom control. On a population level, the proportion of CSU patients with disease control increased from 44.2% to 58.1%. Conclusion In principle, effective CSU medications and a disease‐specific guideline are available. However, implementation of recommendations is lagging in practice. The approach of quantitative modelling of the patient journey validates obstacles and shows a clear effect of multiple interventions on the patient journey. The data generated by our simulation can be used to identify strategies for improving patient care. Our approach might helping in understanding and improving the management of patients beyond CSU.
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2دورية أكاديمية
المؤلفون: Maurer, Marcus, Raap, Ulrike, Staubach, Petra, Richter‐Huhn, Grit, Bauer, Andrea, Oppel, Eva M., Hillen, Uwe, Baeumer, Daniel, Reinhardt, Maximilian, Chapman‐Rothe, Nadine
المساهمون: Novartis Pharma
المصدر: Clinical & Experimental Allergy ; volume 49, issue 5, page 655-662 ; ISSN 0954-7894 1365-2222
الوصف: Summary Background Previous reports indicate that patients with chronic spontaneous urticaria ( CSU ) are undertreated and that physicians show poor adherence to guideline recommendations. Awareness of CSU has improved in recent years, but it remains unclear if this has improved the management of these patients in clinical practice. Objective To describe disease burden, quality of life (QoL), and treatment patterns of patients with H 1 ‐antihistamine‐refractory CSU in Germany. Method A World‐wide Antihistamine‐Refractory chronic urticaria (CU) patient Evaluation ( AWARE ) is a global prospective, non‐interventional study of CU in the real‐world setting, supported by the manufacturer of omalizumab. Patients (18‐75 years) were included who had H 1 ‐antihistamine‐refractory CSU for ≥2 months. Disease characteristics, pharmacological treatments, and QoL (dermatology life quality index [ DLQI ], CU‐QoL questionnaire, and angioedema QoL questionnaire) are reported for patients enrolled in Germany. Results After 1 year in AWARE , CSU remained uncontrolled (urticaria control test [ UCT ] score <12) in 432 of 1032 (42.2%) patients. QoL impairment remained high after 1 year, with 28.2% of patients reporting that CSU had a moderate/very large/extremely large effect on the DLQI . Most patients did not receive guideline‐recommended treatments at the end of the 1‐year observation period. Changes in treatments were most evident at the first patient visit, with an increase in patients receiving omalizumab vs prior therapy from 8.5% to 21.4%, and a decrease in those receiving no treatment from 29.9% to 12.8%. These changes were associated with reduced hives, angioedema, UCT scores, and QoL scores at Month 3, but only modest improvements thereafter. Of 528 patients with uncontrolled CSU and who were eligible for treatment escalation, only 3% received up‐dosing of H 1 ‐antihistamines and only 5% were initiated on omalizumab during 1 year of treatment. Conclusions & Clinical Relevance This study highlights a significant ...
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3دورية أكاديمية
المؤلفون: Maurer, Marcus, Staubach, Petra, Raap, Ulrike, Richter-Huhn, Grit, Bauer, Andrea, Ruëff, Franziska, Jakob, Thilo, Yazdi, Amir Sadegh, Mahler, Vera, Wagner, Nicola, Lippert, Undine, Hillen, Uwe, Schwinn, A., Pawlak, M., Behnke, Norbert, Chaouche, K., Chapman-Rothe, N.
المصدر: Clinical & experimental allergy. - 47, 5 (2017) , 684-692, ISSN: 1365-2222
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4دورية أكاديمية
المؤلفون: Maurer, Marcus, Raap, Ulrike, Staubach, Petra, Richter‐Huhn, Grit, Bauer, Andrea, Oppel, Eva M., Hillen, Uwe, Baeumer, Daniel, Reinhardt, Maximilian, Chapman‐Rothe, Nadine
المصدر: Clinical & Experimental Allergy; May2019, Vol. 49 Issue 5, p655-662, 8p, 1 Chart, 3 Graphs
مصطلحات موضوعية: URTICARIA, THERAPEUTICS, QUALITY of life, ANGIONEUROTIC edema, PHYSICIANS
مصطلحات جغرافية: GERMANY
مستخلص: Summary: Background: Previous reports indicate that patients with chronic spontaneous urticaria (CSU) are undertreated and that physicians show poor adherence to guideline recommendations. Awareness of CSU has improved in recent years, but it remains unclear if this has improved the management of these patients in clinical practice. Objective: To describe disease burden, quality of life (QoL), and treatment patterns of patients with H1‐antihistamine‐refractory CSU in Germany. Method: A World‐wide Antihistamine‐Refractory chronic urticaria (CU) patient Evaluation (AWARE) is a global prospective, non‐interventional study of CU in the real‐world setting, supported by the manufacturer of omalizumab. Patients (18‐75 years) were included who had H1‐antihistamine‐refractory CSU for ≥2 months. Disease characteristics, pharmacological treatments, and QoL (dermatology life quality index [DLQI], CU‐QoL questionnaire, and angioedema QoL questionnaire) are reported for patients enrolled in Germany. Results: After 1 year in AWARE, CSU remained uncontrolled (urticaria control test [UCT] score <12) in 432 of 1032 (42.2%) patients. QoL impairment remained high after 1 year, with 28.2% of patients reporting that CSU had a moderate/very large/extremely large effect on the DLQI. Most patients did not receive guideline‐recommended treatments at the end of the 1‐year observation period. Changes in treatments were most evident at the first patient visit, with an increase in patients receiving omalizumab vs prior therapy from 8.5% to 21.4%, and a decrease in those receiving no treatment from 29.9% to 12.8%. These changes were associated with reduced hives, angioedema, UCT scores, and QoL scores at Month 3, but only modest improvements thereafter. Of 528 patients with uncontrolled CSU and who were eligible for treatment escalation, only 3% received up‐dosing of H1‐antihistamines and only 5% were initiated on omalizumab during 1 year of treatment. Conclusions & Clinical Relevance: This study highlights a significant discrepancy between recommendations for managing CSU in international guidelines, and in real‐world clinical practice in Germany. [ABSTRACT FROM AUTHOR]
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