The patient journey with chronic urticaria in Brazil: a real-life study
A jornada do paciente com urticária crônica no Brasil: um estudo de vida real
Larissa Silva Brandão, Luis Felipe Ensina, Dirceu Solé
Abstract
Introduction: In large, diverse countries like Brazil, geographic disparities and healthcare barriers can significantly affect the chronic urticaria (CU) patient journey and disease outcomes. This study evaluated the real-world burden, regional disparities, and treatment patterns of CU in Brazil. Methods: This cross-sectional study surveyed 388 physician-confirmed CU patients across all Brazilian regions between June 2022 and December 2023, assessing clinical features, diagnostic latency, disease control (UCT), treatments, and quality of life. Results: The cohort was 92% female with 79.1% reporting angioedema. Northeast patients faced longer diagnostic delays (35.3% ≥ 2 years) and greater scarcity of specialized services than Southeast patients. “Diagnostic nomadism” was prevalent, with 41% consulting 3 to 5 physicians before diagnosis, and misdiagnosis affected 53.4%. Uncontrolled disease was alarmingly high (71.6%). Anti-IgE usage was higher in the South (34.9%) than in the Northeast (15.3%). Angioedema severely impacted sexual health and interpersonal relationships. Conclusion: CU imposes a severe burden in Brazil. To address the misdiagnosis trap and regional inequalities, we suggest expanding specialized care, implementing telemedicine in underserved regions, and enhancing medical education to ensure guideline adherence.
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Resumo
Introdução: No Brasil, disparidades geográficas e barreiras de acesso à saúde afetam a jornada do paciente com urticária crônica (UC) e os desfechos da doença. Este estudo avaliou o impacto real, as disparidades regionais e os padrões de tratamento da UC no Brasil. Métodos: Estudo transversal com 388 pacientes com UC confirmada por médico em todas as regiões brasileiras entre junho de 2022 e dezembro de 2023, analisando características clínicas, latência diagnóstica, controle da doença (UCT) e qualidade de vida. Resultados: A coorte incluiu 92% de mulheres, com 79,1% relatando angioedema. Pacientes do Nordeste enfrentaram maiores atrasos diagnósticos (≥ 2 anos: 35,3%) e escassez de especialistas que os do Sudeste. O “nomadismo diagnóstico” foi prevalente, com 41% consultando de 3 a 5 médicos antes do diagnóstico, e o erro diagnóstico afetou 53,4%. O descontrole da doença foi alarmantemente alto (71,6%). O uso de anti-IgE foi significativamente maior no Sul (34,9%) do que no Nordeste (15,3%). O angioedema impactou gravemente a saúde sexual e os relacionamentos interpessoais. Conclusão: A UC impõe grave impacto no Brasil. Para mitigar erros diagnósticos e desigualdades regionais, sugere-se expandir o atendimento especializado, implementar telemedicina em regiões carentes e aprimorar a educação médica para garantir a adesão às diretrizes.
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Referências
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Submetido em:
18/06/2026
Aceito em:
29/07/2026
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