Urticaria Activity Score (UAS7)
7-day urticaria activity score assessing wheals and pruritus, used to guide antihistamine dosing and omalizumab eligibility in chronic spontaneous urticaria (CSU).
Score interpretation
UAS7 0–6: Urticaria well-controlled or in remission.
→ Maintain or step-down treatment. If on standard-dose antihistamine: consider reducing to PRN. If on omalizumab: discuss dose spacing. Trigger identification and avoidance. Allergy review if food/drug triggers suspected.
UAS7 7–15: Mild to moderate chronic spontaneous urticaria.
→ Non-sedating antihistamine (cetirizine 10mg or loratadine 10mg) OD. If inadequate response after 2–4 weeks: up-dose to 4× licensed dose (off-label but EAACI-endorsed). Avoid triggers. BSACI/EAACI guideline.
UAS7 16–42: Moderate to severe CSU. High-dose antihistamine inadequate.
→ Omalizumab 300mg SC every 4 weeks (NICE TA339 — after ≥ 2 antihistamines inadequate). Trial for minimum 6 months. Short course prednisolone (0.5 mg/kg × 5–7 days) for acute exacerbations. Specialist dermatology/immunology referral.
Interpretation bands for the UAS7. Apply clinical judgement and local guidance.
References
- Zuberbier T et al. The EAACI/GA²LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy. 2022.
- NICE TA339. Omalizumab for treating chronic spontaneous urticaria. 2015.
Related
Curated clinical cross-links plus same-class fallbacks.
- Omalizumab (Dermatology — Chronic Urticaria) · Anti-IgE Monoclonal Antibody
- Promethazine · First-Generation Antihistamine — Burns Pruritus / Sedation
- Pindolol · Non-selective β-blocker (with intrinsic sympathomimetic activity)
- Cyproheptadine · Antidote / Antihistamine
- Cetirizine hydrochloride · Non-sedating H1 antihistamine
- Chlorphenamine maleate · Sedating H1 antihistamine
- Suspicious Pigmented Lesion — Melanoma Pathway · NICE NG14 2015 / BAD
- Cellulitis and Erysipelas · NICE NG141 2019 / CREST
- Psoriasis — Severity Assessment and Step-Up Therapy · NICE NG153 2019 / BAD
- Atopic Eczema — Assessment and Step-Up Therapy · NICE NG95 2023
- Urticaria and Angioedema · BSACI / EAACI Guidelines 2022
- Acne Vulgaris — Grading and Treatment · NICE NG198 2021 / BAD
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.