Analysis Group Collaborates with Research Partners to Explore Disparities in Treatment of Patients with Chronic Spontaneous Urticaria
March 2, 2026
Chronic spontaneous urticaria (CSU) is a condition characterized by itching, hives, and tissue swelling lasting over six weeks without an identifiable trigger. The recommended first-line treatment for CSU is H1-antihistamines, and more advanced treatments, such as biologics, can provide targeted approaches to achieving clinical remission. Systemic corticosteroids (prescription medications that reduce inflammation) are recommended for short-term use during acute flare-ups, however frequent and/or prolonged use of systemic corticosteroids can result in serious adverse events (AEs). Despite such treatments, a large proportion of patients experience a prolonged disease journey and health inequities in the care CSU patients receive are not fully understood.
An Analysis Group team led by Vice President Irina Pivneva, Manager Jason Doran, and Associate Frederic Kinkead collaborated with researchers from Novartis on three posters on CSU presented at the American College of Allergy, Asthma & Immunology (ACAAI) 2025 Annual Scientific Meeting. Their research used data from a large US health insurance claims database to evaluate disparities in the management of CSU.
In the first poster, the researchers assessed the treatment patterns and health care resource utilization (HCRU) of CSU patients according to race and ethnicity and insurance coverage. The highest proportion of corticosteroid use and emergency room visits were among Black patients with Medicaid, suggesting more uncontrolled disease in this population. Despite this, only 10% of Black patients with Medicaid received advanced, or biologic, treatment, suggesting disparities in CSU management.
For the second poster, the team examined treatment patterns and HCRU in CSU patients according to specialist visits, including dermatologist and allergist visits. They observed that patients with both allergist and dermatologist visits received higher proportions of biologics as compared with other groups, and that patients who only visited an allergist had a higher degree of biologic use and a shorter wait time to initiate this advanced treatment option as compared with patients who only visited dermatologists or primary care physicians. The researchers observed a high proportion of patients with CSU-related corticosteroid use, inpatient admissions, and emergency room and urgent care visits, suggesting both a high level of uncontrolled disease across all groups and an unmet need for more effective treatment options.
In the third poster, the researchers described systemic corticosteroid use and its associated outcomes in CSU patients in the US. Corticosteroid use, they observed, was associated with the occurrence of adverse events (AEs) such as lipid disorders and hypertension, and prolonged use was generally associated with more frequent AEs and greater AE-related HCRU. The team concluded by noting that provider guidelines support restricting corticosteroids to short-term use and only as a rescue treatment for managing CSU.
The researchers concluded that, while more research is needed, disparities in CSU management do exist and there is an unmet need for more CSU treatment options.