Understanding What Matters Most to Patients with Chronic Urticaria
Chronic urticaria, characterized by persistent hives, itching, and swelling, can disrupt daily life and emotional well-being. A recent systematic review of 18 studies involving more than 28,000 participants sheds light on the values and priorities that patients and caregivers bring to treatment decisions. The findings emphasize that clinical efficacy alone isn’t enough—treatment choices must align with what patients consider most important for their quality of life.
Rapid Relief and Long-Term Control as Top Priorities
The review identifies two core goals that patients consistently rate as paramount: fast symptom relief and durable control of hives, itching, and swelling. When faced with similarly effective options, participants favored treatments that could deliver noticeable improvement quickly, often within days to weeks, and maintain symptom suppression over time. This aligns with the everyday experience of living with chronic urticaria, where timely relief translates into better function at home, work, and social activities.
Balancing Speed, Safety, and Tolerability
Another central theme is the balance between rapid onset of action and safety. Patients preferred strategies that minimized adverse effects and avoided more serious risks, such as those affecting kidney function or requiring invasive monitoring. In practice, this means that a treatment’s safety profile is a defining factor when two options offer comparable control of symptoms. A tolerable safety experience—such as mild injection-site reactions or transient side effects—often tips the decision in favor of one therapy over another.
Practical Considerations in Safety and Efficacy
Beyond the headline outcomes of symptom relief and safety, patients weigh the overall burden of the treatment. For some, a therapy with a slightly slower onset but a safer or more predictable response may be preferable to a faster-acting option with higher risk or variability. The systematic review highlights that the “best” treatment is not always the one with the strongest clinical trial results, but the one that best matches a patient’s tolerance for risk and their personal treatment goals.
Convenience, Autonomy, and Daily Life Impact
Another key finding is the preference for convenient and manageable treatments. Oral or topical therapies are generally favored over injections or infusions, which patients perceive as more burdensome, time-consuming, or disruptive to daily routines. This preference reflects a broader desire for autonomy—being able to manage symptoms with minimal interference from treatment schedules, clinic visits, or procedural requirements. Caregivers also weigh convenience heavily, recognizing its impact on adherence and overall treatment success.
Implications for Clinical Practice
These insights have practical implications for clinicians and healthcare systems. Shared decision-making should foreground patient values—prioritizing rapid relief, durable control, safety, and ease of use. When clinicians discuss options, they should explicitly address: how quickly a therapy tends to work, the expected duration of benefit, common side effects, and the logistical aspects of administration (oral vs. injectable, dosing frequency, monitoring needs).
Adherence is likely to improve when patients feel their preferences are acknowledged and integrated into the treatment plan. For caregivers, transparent conversations about convenience and expected changes to daily life can reduce burden and enhance the overall care experience. Ultimately, aligning treatment choices with patient priorities contributes to higher satisfaction, better quality of life, and sustained disease management.
Looking Ahead
The ongoing synthesis of patient values and preferences in chronic urticaria treatment underscores a shift toward person-centered care. As new therapies emerge, researchers and clinicians should continue to explore how different administration routes, safety profiles, and onset timelines influence real-world adherence and outcomes. The aim is a collaborative approach where patients and clinicians share decision-making, guided by evidence, empathy, and the lived experience of chronic urticaria.
Reference: Chu X et al. Patient values and preferences in chronic urticaria treatment: a systematic review. JAMA Dermatol. 2025;DOI:10.1001/jamadermatol.2025.3663.
