Factors Influencing Acceptance of Biologics and Small Molecule Targeted Drugs Among Patients with Chronic Spontaneous Urticaria: A Cross-Sectional Study

Yang Yang,* Chunjie Gao,* Xiaoya Fei, Ruiping Wang, Wencheng Jiang Department of Dermatology, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ruiping Wang, Department of Dermatology, Shanghai Skin Disease Hospital, School of medicine, Tongji University, Shanghai, 200443, People’s Republic of China, Email [email protected] Wencheng Jiang, Department of Dermatology, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, People’s Republic of China, Email [email protected]: This study aimed to investigate CSU patients’ awareness, attitudes, and acceptance of biologics and small-molecule targeted drugs (SMTD).Materials and Methods: We conducted a single-center cross-sectional survey using a structured questionnaire to collect clinical and demographic data from 711 patients with CSU, along with information on their knowledge of and attitudes toward biologics and SMTD. Multivariable logistic regression analysis was performed to estimate odds ratios (OR) and 95% confidence intervals (CI) to identify factors associated with patients’ acceptance of biologics and SMTD.Results: Among all participants, 53.02% were aware of biologics and SMTD, and 47.81% expressed willingness to use these therapies. Higher education level (college and above; OR = 5.44, 95% CI: 1.09– 27.08), marital status (married; OR = 3.79, 95% CI: 1.29– 11.17), and family history (OR = 5.97, 95% CI: 2.75– 12.95) were positively associated with acceptance. Conversely, alcohol consumption showed an independent negative association (OR = 0.37, 95% CI: 0.15– 0.88). Patients’ awareness of biologics and SMTD (OR = 3.66, 95% CI: 1.85– 7.24), perceived safety (OR = 3.70, 95% CI: 2.16– 6.34) and perceived efficacy (OR = 11.86, 95% CI: 6.79– 20.72) were also strongly associated with willingness to adopt these therapies.Conclusion: This study found that higher educational attainment, marital status, abstinence from alcohol, and a family history of CSU were associated with greater willingness to accept biologics and SMTD, while awareness of these therapies and perceptions of their safety and efficacy were the most influential determinants of treatment acceptance. These findings highlight the importance of improving patient awareness and providing clear, culturally tailored communication to support informed decision-making and facilitate the integration of biologics and SMTD into CSU management in China.Keywords: chronic spontaneous urticaria, CSU, cross-sectional study, biologics, small molecule targeted drugs, SMTD