1. The urticaria control test (UCT) The urticaria control test (UCT)

2. Diagnostic work up in urticaria
Exclude differential diagnoses
It‘s urticaria
Exclude acute urticaria
It‘s chronic urticaria
Exclude chronic inducible urticaria (CIndU)
(Can you make your wheals / angioedema come on?)
It‘s chronic spontaneous urticaria
Check for severe systemic inflammatory disease
Disease activity?, Quality of life impairment?, Disease control?
The special focus of this presentation is the urticaria control test (UCT).

3. Diagnostic work up in urticaria
Exclude differential diagnoses
It‘s urticaria
Exclude acute urticaria
It‘s chronic urticaria
Exclude chronic inducible urticaria (CIndU)
(Can you make your wheals / angioedema come on?)
It‘s chronic spontaneous urticaria
Check for severe systemic inflammatory disease
Disease activity?, Quality of life impairment?, Disease control?
The assessment of disease activity, quality of life impairment, and disease control is important for the management of CSU.

4. Diagnostic work up in urticaria
Exclude differential diagnoses
It‘s urticaria
Exclude acute urticaria
It‘s chronic urticaria
Exclude chronic inducible urticaria (CIndU)
(Can you make your wheals / angioedema come on?)
It‘s chronic spontaneous urticaria
Check for severe systemic inflammatory disease
Disease activity?, Quality of life impairment?, Disease control?
The special focus of this presentation is the urticaria control test (UCT).

5. How to assess disease activity, impact and control in chronic spontaneous urticaria
UAS AAS
CU-Q2oL AE-QoL
UCT
Activity:
Quality of life:
Control:
The UCT is suitable for assessing patients with recurrent wheals, recurrent angioedema, or both.
In contrast, the urticaria activity score (UAS7, for measuring disease activity) and the chronic urticaria quality of life questionnaire (CU-Q2oL, for assessing quality of life impairment) are suitable only for patients with wheals. In CSU patients who also have (or exclusively have) recurrent angioedema, the angioedema activity score (AAS)
and the angioedema quality of life questionnaire (AE-Q2oL) should be used, respectively.

6. How to assess disease activity, impact and control in chronic spontaneous urticaria
UAS AAS
CU-Q2oL AE-QoL
UCT
Activity:
Quality of life:
Control:
The UCT is suitable for assessing patients with recurrent wheals, recurrent angioedema, or both.

7. The urticaria control test (UCT)
Weller et al., J. Allergy Clin. Immunol. 2014, in press
Purpose Assess disease control in patients with chronic urticaria
Documentation Patient (4 questions)
Evaluation Physician / Patient
Ad Hoc evaluation Possible
Assessment period 4 weeks
The UCT is used to determine the level of disease control in patients with chronic urticaria. It consists of 4 questions with five answer options each. These questions are answered by the patient. This takes less than half a minute. The UCT is easy and quick to evaulate (less than half a minute). The UCT looks at the control of disease activity over the past 4 weeks.

8. The urticaria control test (UCT)
Weller et al., J. Allergy Clin. Immunol. 2014, in press
The four questions of the UCT address the control of signs and symptoms of the disease (question 1), quality of life impairment (question 2), efficacy of treatment (question 3), and overall disease control (question 4).

9. The urticaria control test (UCT)
Weller et al., J. Allergy Clin. Immunol. 2014, in press
0 points
1 point
2 points
3 points
4 points
The scoring for the UCT is very easy. Each answer option is awarded 0 to 4 points, from no control (0 points) to complete control (4 points). Thus, a maximum of 4 points per question/answer and a total maximum of 16 points (= complete control) can be achieved.

10. The urticaria control test (UCT)
Weller et al., J. Allergy Clin. Immunol. 2014, in press
0 points
1 point
2 points
3 points
4 points
The more points patients score, the better their control of the disease.

11. 0 to 16 points The urticaria control test (UCT)
Weller et al., J. Allergy Clin. Immunol. 2014, in press
0 to 16 points
The lowest UCT score possible is 0 (no control) and the highest UCT score is 16 (complete control).

12. ✔ ≥12 = The urticaria control test (UCT)
Weller et al., J. Allergy Clin. Immunol. 2014, in press
The urticaria control test (UCT)
Weller et al., J. Allergy Clin. Immunol. 2014, in press ✔
≥12 =
A UCT score of 12 or greater indicates controlled disease. Values of 11 and lower reflect poor control and a need for better treatment.

13. Cross-culturally adapted versions of the UCT
Denmark
Finland UK
Russia
The Netherlands
Poland
Canada (French)
Bulgaria
Spain
Canada (Engl.)
Azerbaijan
China
USA
France
Turkey
Greece
Mexico
Israel
Japan
Italy
India
Venezuela
For more information and for obtaining available versions of the UCT, please visit or send an to
Background reading: Weller, K., Groffik, A., Church, M. K., Hawro, T., Krause, K., Metz, M, Martus, P., Casale, T., Staubach, P., Maurer, M. Development and Validation of the Urticaria Control Test - a patient reported outcome instrument for assessing urticaria control. J. Allergy Clin Immunol. 2014: in press.
Brazil
Australia
South Africa
April 2014
completed
in progress
in preparation

14. The urticaria control test (UCT)
Weller et al., J. Allergy Clin. Immunol. 2014, in press
Should be used at every visit
Provides quick and reliable information
Allows for ad hoc assessment (e.g. at first visit)
Helps to optimize management and treatment
Valid for all forms of chronic urticaria (CSU and CIndU)
Suitable for patients with wheals, angioedema, or both
Take home messages:
The UCT should be done routinely, during the first visit as well as at every follow up visit, to adapt the treatment to the activity and the control of the disease. The UCT allows for reproducible, validated and meaningful ad hoc assessment of disease control. Uncontrolled disease (UCT of 11 or lower) should prompt a change of treatment.