Chronic Spontaneous Urticaria Learning Zone
Transcript: The CRUSE app for CSU management
Sophia Neisinger, MD
All transcripts are created from interview footage and directly reflect the content of the interview at the time. The content is that of the speakers and is not adjusted by Medthority.
- Hi, everyone. My name is Sophia Neisinger. I'm a physician at the Institute of Allergology at Charité in Berlin with a research focus on mast cell-driven diseases and health tech. And today, I'm delighted to present you the following case, a patient with urticaria who has made use of the CRUSE App, during the COVID-19 pandemic, an opportunity to discuss remote administration of PROMs. So, first of all, I want to give you, dear colleagues, some background information. You're all experts, but not everyone is an urticarialogists. So the use of a standardised, valid, and reliable clinical measures is an important element in modern patient management, particularly in diseases that are not objectively accessible. And in urticaria, we do not have that one blood parameter in urticaria that lets us know the patient, for instance, has a well-controlled disease. And this is exactly why we need PROMs. Patient-Reported Outcome Measures to assess disease, activity, impact, and control. And Patient-Reported Outcome Measures are just like validated questionnaires, patient fill out. Here you see the most important ones for chronic spontaneous urticaria for the disease activity. We are using the Urticaria Activity Score, or if patients also have angioedema, the Angioedema Activity Score. Then, a very important one regarding the disease control, we are using the UCT, the Urticaria Control Test, or again, if the patient has angioedema, the AECT. Then there are also PROMs regarding the quality of life, and also the WPAI regarding the work productivity. So those PROMs are normally filled out before the doctor's visit in the waiting room, either on paper or on a tablet or the patients fill those out at home.
This, as you can imagine, can lead to bad data, missing entries, and it's pretty inconvenient for the patient. So very important for me today, for you as a takeaway of this webinar, is that you have one PROM you might start using tomorrow directly in your clinic with your patients that have urticaria. And this is the Urticaria Control Test. You use it once per month and the patient fills it out regarding his past month with his urticaria. As you can see, it's four simple questions. The score goes from zero to 16 points. And let's just maybe go through the questions. In question number one, if the patient has suffered from physical symptoms of the urticaria and he says, "Yeah, I suffered very much." He gets zero points. If his quality of life was somewhat affected by the urticaria in the last four weeks, he gets two points. So as you can see, it's a very simple score. And if the patient has more than 12 points, we say, "His urticaria is well under control." If not, under 12 points, we have to say, "There has to be a change in therapy," for instance. So this is our patient case. This is Frank, a 32-year-old male patient with a chronic spontaneous urticaria with angioedema, he has for the past two years.
And as you can see on the pictures, he has itchy wheals on his forearm and the swelling of his tongue. He has no known trigger and is currently taking omalizumab 300 milligrammes every four weeks, and antihistamine. His follow-up visit in our clinic was cancelled due to a COVID-19 infection. So what we did, we had a follow-up call planned, but the problem here was we did not have Frank's scores. So we did not know how was his urticaria activity, how is his disease controlled. And this is where we need a new tool. And this tool has been developed by UCARE Urticaria Centres of Reference and Excellence. And this new tool is called the CRUSE App. The CRUSE App has been developed by an amazing team under the supervision of Professor Maurer, and with the help of an amazing steering committee, including professors of dermatology and allergology from France over Spain to Turkey and even to Ecuador. The app is for free and the goal is that every patient with urticaria at some point, is going to have this app. So a global rollout is planned. In Germany, it's currently already available in the App Store and in the Google Play Store. And if you want that, maybe your country is the next, we can launch the app in your country. Just let us know. So how does the app work? The patient just registers or he can also skip registrations.
And then he fills out his questionnaires every day in a very easy and convenient way. And this includes all the scores we want, the UAS, the UCT, the WPAI, and his impact on his quality of life. And this is what Frank did. He filled out his scores, and then, as you can see on the last screenshot on the right side, this is his report and he has sent this report to us via email. Frank had an UCT, you remember there was a score the PROM from before of four points. Four points, as we remember, that's a pretty bad score. So his therapy has to be adjustment. And with urticaria, we are always talking about a rare disease. But if we think about how many patients are affected, it's globally over 50 million people who have a chronic urticaria. And now imagine if we can generate high-quality data of those users in real-time to find better cures. And this is what we can do with CRUSE App. And the most important question, of course, is, do our patients really want and need an app? And here I can just recommend the study. It's a UCARE study called CURICT by Professor Chérrez-Ojeda from Ecuador, and he has asked his chronic urticaria patients if they want an app. And over half of the patients answered this question with, yes, they do want an app to better monitor their disease. So thank you for your time. If you have any further questions regarding PROMs, regarding the CRUSE App or AI or machine learning in dermatology or allergology, feel free to reach out to me via email. And also, thanks to Novartis, the platinum sponsor of the CRUSE App for their continuous support. Thanks a lot.
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This content has been developed independently by Medthority who previously received educational funding from Novartis in order to help provide its healthcare professional members with access to the highest quality medical and scientific information, education and associated relevant content.