A validation study of the Japanese version of the Angioedema Activity Score (AAS) and the Angioedema Quality of Life Questionnaire (AE-QoL)

Background: Recurrent angioedema (RecAE) has a substantial impact on patients' daily lives. However, there have been no disease-specific patient-reported outcomes (PROs) available in Japan to measure disease activity and health-related QoL impairment in such patients. Methods: Japanese versions of the Angioedema Activity Score (AAS) and the Angioedema Quality of Life Questionnaire (AE-QoL) were examined for their validity and reliability. By using these questionnaires, the relationship between disease activity and QoL impairment among the Japanese population of RecAE were analyzed in real-world setting. Results: The Japanese AAS and AE-QoL domains showed good internal consistency of 0.967 and > 0.835. For known group validity, AAS28 and AE-QoL total scores were higher in more severe patients than those with milder disease and QoL impairment, respectively. AAS28 showed strong correlation with indexes of disease activity, while the AE-QoL total score correlated with Dermatology Life Quality Index (DLQI). Sufficient reproductivity of the AAS and AE-QoL was shown by their intraclass correlation coefficients of 0.890 and 0.700. The Japanese population is characterized by the total score of AAS28, 34.3 +/- 38.8 (mean +/- SD); and AE-QoL, 38.7 +/- 25.2. Each domain score of AE-QoL was 32.4 +/- 29.7 in Functioning, 35.0 +/- 27.8 in Fatigue/mood, 50.7 +/- 30.6 in Fears/shame, or 24.7 +/- 29.8 in Food. Changes in AAS28 and AE-QoL positively correlated to Patient global assessment of disease activity and DLQI, respectively. Conclusions: The Japanese AAS and AE-QoL are valid and reliable instruments for Japanese patients with RecAE, and active disease affecting QoL. They help assess disease activity and QoL of RecAE in routine patient care and clinical trials. Copyright (C) 2021, Japanese Society of Allergology. Production and hosting by Elsevier B.V.

Automated summary

The study confirmed the validity and reliability of the Japanese versions of the Angioedema Activity Score (AAS) and the Angioedema Quality of Life Questionnaire (AE-QoL) in assessing disease activity and health-related quality of life impairment in patients with recurrent angioedema (RecAE).