Acquired Cold Urticaria Severity Index (ACUSI)

The ACUSI is a short questionnaire to assess the severity of disease in patients with acquired cold urticaria. The ACUSI is easy to use and evaluate, meaningful and suitable for all patients with acquired cold urticaria, regardless of the underlying causes. The ACUSI is used in the routine care of patients with cold urticaria, in research projects and in clinical studies.

The ACUSI was developed at the Charité by a team headed by Dr. Frank Siebenhaar and Dr. Marcus Maurer. It consists of four questions with three or four possible answers each. The scores of the four questions are added together. Based on the total score achieved, the severity of the patient's illness is assessed. The more points achieved, the higher the severity of cold urticaria.

In contrast to the disease activity of cold urticaria, the evaluation of disease severity is based on the overall experience of patients with their cold urticaria since its onset. While the disease activity of cold urticaria is variable, for example, when contact with cold is more frequent or less frequent or when therapy is initiated, the severity of cold urticaria changes little over time and increases but does not decrease when this happens. The ACUSI is therefore not suitable for continuous monitoring of disease activity or for evaluating the effectiveness of treatment. Rather, the ACUSI is used at the initial medical contact of patients or before participation in a clinical trial, with the aim of differentiating between patients with severe, moderate and mild cold urticaria.

The ACUSI has not yet been validated. For the assessment of disease severity using a tool developed and validated according to guidelines, we recommend the use of the Severity Index Cold Urticaria, SICU.

Quick Facts ACUSI:
Number of questions: 4
Suited for: Adults (≥18 years old) with cold urticaria
Period queried: Duration of illness since onset
Evaluation: Total score (minimum: 4, maximum: 15)
Time required: <1 minute
Evaluation time: <1 minute
Copyright: Moxie GmbH (www.moxie-gmbh.de)
Terms of Use: The use of the ACUSI in routine clinical care as well as in the context of non-commercial research is free of charge. For use in clinical studies or commercial research, a small user fee is charged.

Reference:
Siebenhaar, F., Degener, F., Zuberbier, T., Martus, P., and Maurer, M.: High-dose desloratadine decreases wheal volume and improves cold provocation thresholds compared with standard-dose treatment in patients with acquired cold urticaria: a randomized, placebo-controlled, crossover study. J. Allergy Clin. Immunol. 2009: 123; 672-679.