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Global Real-World Validation of First-Day Urticaria Activity Score (UAS1).

Lanka Huidong Su1, Bernardo Sousa Pinto2, Aiste Ramanauskaite3

  • 1Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China.

The Journal of Allergy and Clinical Immunology. in Practice
|April 22, 2026
PubMed
Summary

The first-day Urticaria Activity Score (UAS1) effectively estimates disease severity in chronic spontaneous urticaria (CSU), serving as a reliable proxy for the weekly UAS7. This score aligns with disease control and quality of life measures, supporting treatment goals.

Keywords:
Chronic spontaneous urticariaPatient-reported outcome measuresmHealth

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Area of Science:

  • Dermatology
  • Clinical Research
  • Patient-Reported Outcomes

Background:

  • Chronic spontaneous urticaria (CSU) management relies on the weekly Urticaria Activity Score (UAS7) as a key patient-reported outcome measure (PROM).
  • Consistent UAS7 data collection in real-world practice presents challenges.
  • Exploring alternative measures is crucial for effective CSU monitoring.

Purpose of the Study:

  • To evaluate the first-day Urticaria Activity Score (UAS1) as a proxy for the UAS7 in a global real-world setting.
  • To assess the association of UAS1 with the Urticaria Control Test (UCT) and EQ-5D visual analogue scale (VAS).
  • To validate UAS1 as a pragmatic tool for assessing CSU disease activity.

Main Methods:

  • Analysis of baseline data from 13,152 CSU patients across 101 countries via the international CRUSE app.
  • Inclusion of 1,520 patients with complete UAS7 records for analysis.
  • Examination of cross-sectional associations using Spearman correlations, regression models, and diagnostic accuracy metrics, stratified by phenotype.

Main Results:

  • UAS1 demonstrated a strong correlation with UAS7 (r = 0.78; P < 0.001) across all phenotypes.
  • A UAS1 threshold of >3 accurately identified patients with severe disease activity (UAS7 ≥28).
  • Both UAS1 and UAS7 showed moderate-to-strong inverse correlations with UCT and EQ-5D VAS, indicating alignment with disease control and quality of life.

Conclusions:

  • UAS1 is a valid and pragmatic proxy for UAS7 in chronic spontaneous urticaria.
  • UAS1 meaningfully correlates with measures of disease control (UCT) and quality of life (EQ-5D VAS).
  • UAS1 can be utilized when UAS7 data is incomplete, supporting treat-to-target strategies for complete disease control.