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Funding for the AWARE Study was provided by Novartis Pharmaceuticals, Spain.

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Borbujo, JAuthorTejedor-Alonso, M AAuthor
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A Specialized Therapeutic Approach to Chronic Urticaria Refractory to H1-Antihistamines Improves Disease Burden: The Spanish AWARE Experience

Publicated to:Journal Of Investigational Allergology And Clinical Immunology. 32 (3): 191-199 - 2022-01-01 32(3), DOI: 10.18176/jiaci.0661

Authors: Gimenez-Arnau, A; Bartra, J; Ferrer, M; Jauregui, I; Borbujo, J; Figueras, I; Munoz-Bellido, F J; Pedraz, J; Serra-Baldrich, E; Tejedor-Alonso, M A; Velasco, M; Terradas, P; Labrador, M

Affiliations

Clin Univ Navarra, ARADyAL, Pamplona, Spain - Author
Complejo Asistencial Univ Salamanca, Salamanca, Spain - Author
Fdn Hosp Alcorcon, Madrid, Spain - Author
Hosp Arnau Vilanova, Valencia, Spain - Author
Hosp Bellvitge Princeps Espanya, Barcelona, Spain - Author
Hosp del Mar, Passeig Maritim de la Barceloneta 25-29, Barcelona 08003, Spain - Author
Hosp Fuenlabrada, Madrid, Spain - Author
Hosp Quiron, Madrid, Spain - Author
Hosp Santa Creu & Sant Pau, Barcelona, Spain - Author
Hosp Univ Cruces, Vizcaya, Spain - Author
Hosp Valle De Hebron, ARADyAL, Barcelona, Spain - Author
Novartis Farmaceut, Barcelona, Spain - Author
Univ Barcelona, Hosp Clin, Pulmonol Dept, Allergy Sect,IDIBAPS,ARADyAL, Barcelona, Spain - Author
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Abstract

Objective: During its first year, the AWARE study assessed disease activity, patient quality of life (QOL), and treatment patterns in chronic urticaria (CU) refractory to H1-antihistamines (H1-AH) in clinical practice. Methods: We performed an observational, prospective (24 months), international, multicenter study. The inclusion criteria were age _>18 years and H1-AH-refractory CU (>2 months). At each visit, patients completed questionnaires to assess disease burden (Urticaria Control Test [UCT]), disease activity (7 day-Urticaria Activity Score [UAS7]), and QOL (Dermatology Life Quality index [DLQI], Chronic Urticaria Quality of Life Questionnaire [CU-Q2oL], and Angioedema Quality of Life Questionnaire [AE-QoL]). We present data for Spain. Results: The study population comprised 270 evaluable patients (73.3% female, mean [SD] age, 48.9 [14.7] years). At baseline, 89.3% were prescribed a CU treatment. After 1 year, first-and second-line treatments became less frequent and third-line treatments became more frequent. At baseline, 47.0% of patients experienced angioedema; at 1 year, this percentage had fallen to 11.8%. The mean (SD) AE-QoL score decreased from 45.2 (28.7) to 24.0 (25.8). The mean (SD) UCT score decreased from 7.0 (4.5) to 12.1 (4.1). According to UAS7, 38.2% of patients reported absence of wheals and itch in the previous 7 days at 1 year compared with 8.3% at baseline. The mean (SD) DLQI score decreased from 8.0 (7.4) to 2.8 (4.6). At the 1-year visit, the percentage of patients reporting a high or very high impact on QOL fell from 29.9% to 9.6%. Conclusions: H1-AH-refractory CU in Spain is characterized by absence of symptoms and a considerable impact on QOL. Continuous follow-up of CU patients and third-line therapies reduce disease burden and improve patients' QOL.

Keywords
AdolescentAngioedemaChronic diseaseChronic urticariaClinical practiceCost of illnessEpidemiologyFemaleHistamine h1 antagonistsHumansImpactMaleManagementMiddle agedOmalizumabProspective studiesQuality of lifeQuality-of-lifeSpainUrticariaValidation

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Journal Of Investigational Allergology And Clinical Immunology due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2022, it was in position 5/28, thus managing to position itself as a Q1 (Primer Cuartil), in the category Allergy.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 1.07, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions May 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-05-11, the following number of citations:

  • WoS: 2
  • Scopus: 2
  • Europe PMC: 1
  • OpenCitations: 2
Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-05-11:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 17.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 16 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 2.
  • The number of mentions on the social network X (formerly Twitter): 3 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.