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In chronic spontaneous urticaria (CSU), the weekly urticaria activity score (UAS) is widely used to evaluate disease activity from the patient's perspective.
First-day urticaria activity score (UAS1) accurately reflects weekly disease activity and quality-of-life impairment in chronic spontaneous urticaria.
In chronic spontaneous urticaria (CSU), the weekly urticaria activity score (UAS) is widely used to evaluate disease activity from the patient's perspective. However, maintaining complete 7-day scoring in routine clinical practice and real-world studies is often cumbersome.
This study investigated whether the first-day UAS (UAS1) could reliably reflect UAS over 7 days (UAS7) results and explored its link with the Urticaria Control Test (UCT) and the EuroQol 5-Dimensions visual analog scale (EQ-5D VAS) in a large international real-world population.
Baseline data from 13,152 patients with CSU across 101 countries were analyzed via the international Chronic Urticaria Self-Evaluation app. Among them, 1,520 patients had complete UAS7 data available. Researchers evaluated cross-sectional relationships between UAS1, UAS7, UCT, and EQ-5D VAS through Spearman correlation analyses, regression models, and diagnostic performance assessments. Analyses were also carried out according to disease phenotype, including wheals alone and wheals accompanied by angioedema.
UAS1 exhibited a strong positive correlation with UAS7 (r = 0.78; P < .001) across all symptom phenotypes. A UAS1 score above 3 accurately identified those with severe disease activity, defined as UAS7 ≥28. Both UAS1 and UAS7 illustrated moderate-to-strong negative correlations with UCT (r = –0.53 to –0.58) and EQ-5D VAS (r = –0.47 to –0.54), while UCT and EQ-5D VAS were positively associated (r = 0.46). Similar findings were noted across different symptom subgroups.
The findings validate UAS1 as a practical and reliable substitute for UAS7 in real-world settings. UAS1 also closely reflects disease control and quality-of-life outcomes. In situations where complete UAS7 records are unavailable because of missing daily entries, UAS1 may offer a dependable alternative for estimating disease activity and guiding treat-to-target management aimed at achieving complete symptom control and normal quality of life.
The Journal of Allergy and Clinical Immunology: In Practice
Global Real-World Validation of First-Day Urticaria Activity Score (UAS1)
Lanka Huidong Su et al.
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