The Angioedema Control Test (AECT) is a useful for evaluating changes in disease control in patients with recurrent angioedema, such as in the case of chronic urticaria or hereditary angioedema (HAE), according to a study published in Clinical and Translational Allergy.
Recurrent angioedema is often unpredictable and can cause considerable distress among patients because the symptoms and episodes can be painful and disfiguring. At times, they can even be life-threatening. Because these episodes come and go, it is difficult to establish the extent of disease control.
Clinicians often rely on patient-reported outcomes to understand how the disease impacts a patient’s daily life. The AECT was developed specifically with this in mind. The test has good internal consistency and test-retest reliability, and has been used by physicians to track disease progression and changes over time.
The authors of the study sought to further investigate how well the AECT is able to evaluate disease control, including the minimal clinically important difference (MCID), which is the smallest change that a patient identifies as meaningful. The research team consecutively recruited German-speaking patients with recurrent angioedema who were seen at the Angioedema Center of Reference and Excellence of the Institute of Allergology of the Charité—Universitätsmedizin in Berlin, Germany. Participants were aged 12 years or older.
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Selected participants were asked to fill in the AECT questionnaire. In addition, they were asked to self-rate their global angioedema control, changes in global disease control, and treatment insufficiency on a 7-point Likert scale. Participants were also asked to fill in the Angioedema Quality of Life Questionnaire (AE-QoL). The researchers determined the MCID to be 6 points on the AE-QoL and 3 points on the AECT.
Sixty-six patients were recruited for this study; 59% had bradykinin-mediated angioedema and 36% had mast cell-mediated angioedema. HAE associated with C1-inhibitors was the most frequent diagnosis at 41%. The median AECT score was 10 at baseline and 13 at follow-up.
The researchers reported that changes in the AECT closely reflected changes in angioedema control, health-related QoL, and treatment efficiency, which demonstrates its value in tracking disease changes over time. In addition, the determination of the MCID as being 3 points on the AECT may serve as a guide to physicians when interpreting AECT scores.
“In conclusion, the AECT is a valuable tool to measure levels and changes of angioedema control in patients with recurrent angioedema and is thus a suitable tool for assessing treatment responses,” the authors wrote.
Fijen L, Vera C, Buttgereit T, et al. Sensitivity to change and minimal clinically important difference of the angioedema control test. Clin Transl Allergy. Published online August 7, 2023. doi:10.1002/clt2.12295.