Prevalence, Comorbidities, and Current Management of Chronic Spontaneous Urticaria in Japan: Retrospective Claims Database Study

Chronic spontaneous urticaria (CSU) affects 0.5%-1.0% of the population worldwide. However, information on the prevalence, comorbidities, and treatment patterns of CSU in Japan is limited. This observational study consisted of a cross-sectional and longitudinal part. The prevalence and incidence of CSU were estimated using the JMDC claims database (JMDC Inc., Tokyo, Japan). CSU was defined as either 'idiopathic urticaria', 'other urticaria' or 'unspecified urticaria' based on ICD-10 codes and prescribed H₁-antihistamines for ≥ 6 weeks over a 3-month period. Comorbidities, current treatments, and healthcare resource utilization in patients with CSU were also evaluated. The prevalence of CSU increased from 1.2% in 2016 to 1.6% in 2021 with a peak in children, while the incidence of CSU remained constant (0.7%-0.8%). Both prevalence and incidence were higher in females. Comorbid allergic rhinitis and conjunctivitis were frequent in the overall population, while comorbid asthma and atopic dermatitis were frequent in patients aged ≤ 11 years. During the 1-year observational period, approximately 95% of patients used H₁-antihistamines, followed by topical steroids, which are not recommended in the guidelines. Patients receiving the treatment in the same step as the initial month constituted the highest proportion represented during the following year. Oral corticosteroid use was relatively high, including in children, whereas omalizumab use was limited. The estimated recent prevalence and incidence of CSU in Japan were 1.6% and 0.8%, respectively. We also described patient characteristics and healthcare resource use. The present study encourages standardized practice for uncontrolled patients with CSU in Japan. Trial Registration: UMIN Clinical Trials Registry: UMIN-CTR 000051032.