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Background and Importance Chronic urticaria markedly impairs quality of life through pruritus, angioedema, sleep disturbances and activity limitations. Biologic therapies such as omalizumab and dupilumab are established options for antihistamine-refractory chronic urticaria, but real-world longitudinal data combining patient-reported outcome measures (PROMs) are scarce. Understanding PROM trajectories in clinical practice is crucial for optimising patient management.Aim and Objectives To evaluate longitudinal changes in quality of life, disease control, activity, work role functioning and treatment satisfaction using CU-Q2oL, Urticaria Control Test (UCT), Urticaria Activity Score 7 (UAS7), PROMIS-29, Work Role Functioning Questionnaire (WRFQ) and TSQM in patients with chronic urticaria treated with biologics.Material and Methods Observational prospective multicentre study including 37 patients with chronic urticaria. Mean age was 46 years; 67% were women. Most patients received omalizumab (92.3%), PROMs were collected at baseline, 1 month, 6 months and 12 months. Paired and mixed-effects analyses were applied where feasible.Results At baseline, CU-Q2oL scores indicated substantial burden (pruritus 41.7, daily activities 19.4, sleep 33.2, global impact 24.4). At 1 year, improvements were observed (15.9, 8.7, 25.9 and 17.2, respectively). UCT increased from 8.8 to 12.1, with significant gains from month 1 (p<0.01). UAS7 decreased from 15.6 to 7.3, showing clinically relevant reduction.PROMIS-29 showed a significant reduction in fatigue (54.5 → 48.6, p=0.001), with favourable trends in anxiety (58.8 → 53.7), depression (52.4 → 49.0) and physical function (51.0 → 57.0). Pain interference increased slightly (51.6 → 55.6).WRFQ global score improved from 88.8 at baseline to 98.9 at 12 months, with all domains (work scheduling, output, physical, mental, social demands) approaching maximal functioning, although without statistical significance due to small, paired samples and ceiling effect.TSQM at 12 months reflected high treatment satisfaction: convenience 66.7, effectiveness 72.2, side effects 100, global satisfaction 78.6, total 79.4.Conclusion and Relevance In this real-world multicentre cohort, biologic therapy for chronic urticaria was associated with sustained improvements across multiple PROMs. CU-Q2oL, UAS7 and PROMIS-29 confirmed clinically meaningful benefits, with fatigue showing statistically significant improvement. WRFQ demonstrated near-complete work role functioning and TSQM highlighted high treatment satisfaction. These findings support the effectiveness of biologics in routine care and underscore the importance of PROMs for patient-centred monitoring and therapeutic decisions.Conflict of Interest No conflict of interest