Monitoring
Patients should be assessed for disease activity, impact, and control
at every follow-up visit using validated patient-reported outcome measures
(PROMs) (eg UAS, UAS7, AAS, CU-Q2oL, AE-QoL, UCT, AECT). Recommended tools to
monitor disease activity in patients with chronic spontaneous urticaria:
- Patients with angioedema, with or without wheals: AAS
- Patients with wheals and angioedema: Both UAS7 and AAS
Recommended
tools to assess disease control based on symptoms:
- Patients with wheals, with or without angioedema: UCT; CU-Q2oL may also be used
- Patients with angioedema, with or without wheals: AECT; AE-QoL may also be used
- Patients with wheals and angioedema: Both UCT and AECT; CU-Q2oL and AE-QoL may also be used
Disease Control of Chronic Urticaria
Complete Control
It is the absence of signs or symptoms of the disease during treatment.
PROMs:
- UAS7 = 0
- UCT = 16
- Angioedema absent (AAS7/8 = 0)
- Optimal quality of life (dermatology life quality index [DLQI] = 0-1)
Good Control
There is a decrease in symptoms or signs during treatment at an
appropriate level as concluded by both the physician and the patient.
PROMs:
- UAS7 = 1-6
- UCT = ≥12
- Angioedema present (AAS7/8 = >0)
- Good quality of life (DLQI = 2-5)
Partial Control
There is a decrease in the intensity of the symptoms or signs while
treatment is ongoing, but an adequate level has not been achieved yet based on
the physician’s and the patient's assessment, and normal quality of life has
not been achieved yet.
PROMs:
- UAS7 = >6
- UCT = <12
- Angioedema present (AAS7/8 = >0)
- With significant impact on quality of life (DLQI = >5)
Absence of Control
It is the absence of evident positive changes in the symptoms and
quality of life of the patient after treatment initiation.