A Concordance Study between Patient Acceptable Symptom State (PASS) and Disease Activity in Chronic Spontaneous Urticaria

Introduction: The Patient Acceptable Symptom State (PASS), a patient-reported outcome measure, has demonstrated correlations with disease severity in various conditions, including psoriasis and scleroderma. However, the clinical relevance of PASS in the context of chronic spontaneous urticaria (CSU) remains to be fully elucidated. Objectives: This study aimed to determine the prevalence of PASS among CSU patients, identify potential predictors, and establish the weekly urticaria activity score (UAS7) threshold for PASS. Methods: Demographic and clinical data from CSU patients were prospectively collected. PASS attainment was assessed using a single-item questionnaire. Logistic regression analysis and interaction effects analysis were employed to identify predictors associated with achieving PASS (PASS-Y) or failing to achieve PASS (PASS-N). The UAS7 threshold corresponding to PASS was determined through receiver operating characteristic (ROC) curve analysis. Results: A total of 161 CSU patients were enrolled in this study. Among them, 70.5% exhibited non-severe disease activity (UAS7<28) and achieved PASS-Y. Logistic regression analysis revealed a significant association between UAS7 scores and PASS status (AOR=1.105, P<0.001). Female patients with severe disease activity (UAS7≥ 28) were significantly less likely to achieve PASS-Y compared to their male counterparts (AOR=3.514, P=0.042). ROC analysis identified a UAS7 threshold of 21.5 for predicting PASS, with an area under the curve (AUC) of 0.821. Conclusions: In patients with CSU, PASS demonstrates a strong correlation with UAS7 scores and is straightforward to implement. It may serve as a valuable complementary tool to UAS7 in clinical settings, facilitating a rapid, patient-centered assessment of disease activity.