Treatment Preferences in Adults With Chronic Spontaneous Urticaria in Italy: Insights From the CHOICE-CSU 2 Study
Author(s)
Lucia Casoli, PhD1, Ornella Bonavita2, Diletta Valsecchi3, Alice Messi, M.Sc.4, Eustachio Nettis, MD5, panagiotis Orfanos, BSc, MPhil, MSc6, Ravneet Kaur Kohli7, Cristina Constantinescu8.
1P, R & HEOR Manager, Novartis Farma S.p.A., Milano, Italy, 2Novartis Farma S.p.A., Italy, 3Novartis Farma S.p.A., Milano, Italy, 4Novartis Farma S.p.A., Milan, Italy, 5Regional Reference Center for Allergic and Immunological Diseases - Department of Precision and Regenerative Medicine and Ionian Area - University of Bari, Bari, Italy, 6Novartis Pharma AG, Basel, Switzerland, 7Novartis Healthcare Pvt. Ltd., Bengaluru, India, 8Ipsos, Switzerland.
1P, R & HEOR Manager, Novartis Farma S.p.A., Milano, Italy, 2Novartis Farma S.p.A., Italy, 3Novartis Farma S.p.A., Milano, Italy, 4Novartis Farma S.p.A., Milan, Italy, 5Regional Reference Center for Allergic and Immunological Diseases - Department of Precision and Regenerative Medicine and Ionian Area - University of Bari, Bari, Italy, 6Novartis Pharma AG, Basel, Switzerland, 7Novartis Healthcare Pvt. Ltd., Bengaluru, India, 8Ipsos, Switzerland.
OBJECTIVES: Chronic spontaneous urticaria (CSU) is a condition marked by recurrent itching and hives, with or without angioedema, persisting for more than six weeks in the absence of identifiable external triggers. As new therapeutic options emerge, it becomes increasingly important to understand which treatment characteristics are most valued by patients. The CHOICE-CSU 2 study explored these preferences among Italian adults with CSU symptomatic despite treatment with H1-antihistamines.
METHODS: A quantitative online survey was conducted among Italian adults with CSU inadequately controlled by H1-antihistamines. The attributes are derived from literature, qualitative insights from advisory boards with CSU patients and a previous preference study CHOICE-CSU 1. Participants were recruited through various channels, including patient panels, advocacy groups, and specialist referrals. The study employed Maximum Difference Scaling (MaxDiff) and Discrete Choice Experiment (DCE) methodologies to determine the relative weight patients assign to treatment features and to assess preferences between hypothetical therapy profiles. Sensitivity analysis with scenarios of parity in efficacy were conducted to assess robustness of the results.
RESULTS: The analysis included 75 patients with CSU (median age 38 years, 72% women). Over 70% experienced angioedema, with an average frequency of 5.5 episodes per month. Sixty-three percent of patients were diagnosed by an allergist, with 44% having a condition for over 5 years. Despite treatments, patients reported poor control of urticaria (median UCT score: 6). According to MaxDiff results, the top five prioritized attributes were: well-controlled urticaria, impact on QoL, fast onset of treatment effect, side effects, and effect on swelling. In evaluating preferences between hypothetical therapy profiles with comparable efficacy via DCE, 53.6% of patients preferred oral treatment over injectable.
CONCLUSIONS: Patients slightly prefer oral CSU treatments over injectables when efficacy and safety are comparable. The most important attributes patients consider are well-controlled urticaria, QoL and fast onset of treatment effect.
METHODS: A quantitative online survey was conducted among Italian adults with CSU inadequately controlled by H1-antihistamines. The attributes are derived from literature, qualitative insights from advisory boards with CSU patients and a previous preference study CHOICE-CSU 1. Participants were recruited through various channels, including patient panels, advocacy groups, and specialist referrals. The study employed Maximum Difference Scaling (MaxDiff) and Discrete Choice Experiment (DCE) methodologies to determine the relative weight patients assign to treatment features and to assess preferences between hypothetical therapy profiles. Sensitivity analysis with scenarios of parity in efficacy were conducted to assess robustness of the results.
RESULTS: The analysis included 75 patients with CSU (median age 38 years, 72% women). Over 70% experienced angioedema, with an average frequency of 5.5 episodes per month. Sixty-three percent of patients were diagnosed by an allergist, with 44% having a condition for over 5 years. Despite treatments, patients reported poor control of urticaria (median UCT score: 6). According to MaxDiff results, the top five prioritized attributes were: well-controlled urticaria, impact on QoL, fast onset of treatment effect, side effects, and effect on swelling. In evaluating preferences between hypothetical therapy profiles with comparable efficacy via DCE, 53.6% of patients preferred oral treatment over injectable.
CONCLUSIONS: Patients slightly prefer oral CSU treatments over injectables when efficacy and safety are comparable. The most important attributes patients consider are well-controlled urticaria, QoL and fast onset of treatment effect.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
PCR249
Topic
Health Service Delivery & Process of Care, Patient-Centered Research, Real World Data & Information Systems
Topic Subcategory
Patient Behavior and Incentives
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)