Patients with chronic spontaneous urticaria (CSU) with a urticaria activity score (UAS) of less than three are very likely to achieve a complete response to standard-dose antihistamine (AH) treatment, and patients with a UAS of less than four are very likely to achieve a complete response to higher than standard-dose AH treatment, according to a study published in International Archives of Allergy and Immunology.
“The use of predictors of response to a specific treatment in patients with CSU can improve disease management, help prevent unnecessary healthcare costs, and save time,” the study authors wrote.
Utilizing the medical records of 475 patients with CSU, the researchers sought to identify predictors of complete response to standard-dose and higher than standard-dose AH treatment. They used traditional statistical methods as well as 15 machine learning (ML) models to predict complete response to standard-dose and higher than standard-dose AH treatment according to 17 clinical parameters.
CSU Disease Activity Was Only Clinical Predictive Parameter
The study team found that CSU disease activity was the sole clinical parameter that predicted complete response to standard-dose and higher than standard-dose AH treatment, for all ages, with both traditional statistic measurements and ML models.
According to receiver operating characteristic (ROC) analyses, optimal cut-off values of disease activity to predict complete response were a UAS of less than 3 and a UAS of less than 4 for standard-dose (area under the ROC curve [AUC]=0.69; P=0.001) and higher than standard-dose (AUC, 0.79; P=0.001) AH treatments, respectively.
ML models also detected lower total IgE (<150 IU/mL) as a predictor of complete response to a standard-dose AH and lower C-reactive protein (<3.4 mg/mL) as a predictor of complete response to higher than standard-dose AH treatment.
“We showed that patients with UAS less than 3 are highly likely to have complete response to standard-dosed [AH], and those with a UAS less than 4 are highly likely to have complete response to higher than standard-dosed [AH] treatment,” the study authors wrote. “Low CSU disease activity is the only universal predictor of complete response to [AH] treatment with both ML models and traditional statistics for all age groups.”
