How to assess disease activity in patients with chronic urticaria?

Abstract

Background The current EAACI/GA(2)LEN/EDF guidelines recommend assessing disease activity in chronic urticaria (CU) by using an established and well-defined symptom score, i.e. the urticaria activity score (UAS), which combines daily wheal numbers and pruritus intensity. However, this UAS has never been formally tested for its suitability in assessing CU activity. Aim To determine the UAS correlation with quality of life (QoL) in CU patients and to compare the UAS to other symptom scores. Methods Chronic urticaria symptoms (wheals, erythema, angioedema, pruritus) were assessed on seven consecutive days in 111 CU patients for their numbers, duration, size, and/or intensity. Quality of life was assessed by using the Dermatology Life Quality Index. Both, urticaria activity and QoL were determined before and after a 3-week period, in which the patients followed a pseudoallergen-low diet. Results Urticaria activity score values correlated positively, albeit weakly, with QoL impairment in CU patients (r(2) = 0.31, P Conclusions Our findings back the current guideline recommendations to use the UAS for monitoring disease activity in CU patients. Urticaria activity score mean values of at least four consecutive days should be used.