Cut-off points for defining asthma control in three versions of the Asthma Control Questionnaire

Asthma is a chronic inflammatory airway disease, associated with systemic inflammation. Omega-3 polyunsaturated fatty acids (n-3 PUFA) have established anti-inflammatory effects, thus having potential as an adjunct therapy in asthma. This study aimed to compare erythrocyte n-3 PUFA in adults with (n = 255) and without (n = 137) asthma and determine the relationship between erythrocyte n-3 PUFA and clinical asthma outcomes. Subjects had blood collected, lung function measured and Juniper Asthma Control Questionnaire (ACQ) score calculated. Fatty acids were measured in erythrocyte membranes by gas chromatography, and the omega-3 index (O3I) was calculated (% eicosapentaenoic acid + % docosahexaenoic acid). O3I was similar in subjects with and without asthma (p = 0.089). A higher O3I was observed in subjects with controlled or partially controlled asthma (ACQ < 1.5) compared to subjects with uncontrolled asthma (ACQ ≥ 1.5) (6.0% (5.4–7.2) versus 5.6% (4.6–6.4) p = 0.033). Subjects with a high O3I (≥8%) had a lower maintenance dose of inhaled corticosteroids (ICS) compared to those with a low O3I (<8%) (1000 μg (400–1000) versus 1000 μg (500–2000) p = 0.019). This study demonstrates that a higher O3I is associated with better asthma control and with lower ICS dose, suggesting that a higher erythrocyte n-3 PUFA level may have a role in asthma management.

Download Full-text

Use of the Asthma Control Questionnaire by the Asthma Clinical Research Network

European Respiratory Journal ◽

10.1183/09031936.00054711 ◽

2011 ◽

Vol 38 (5) ◽

pp. 1242-1242

Author(s):

M. J. Walter ◽

M. Castro ◽

E. Israel ◽

C. A. Sorkness ◽

Keyword(s):

Clinical Research ◽

Asthma Control ◽

Research Network ◽

Asthma Control Questionnaire ◽

Clinical Research Network

Download Full-text

Body Mass Index and Comorbidities in Adult Severe Asthmatics

BioMed Research International ◽

10.1155/2014/607192 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 17

Author(s):

Andreina Bruno ◽

Elisabetta Pace ◽

Fabio Cibella ◽

Pascal Chanez

Keyword(s):

Asthma Control ◽

Severe Asthma ◽

Type Ii Diabetes ◽

Cross Sectional Study ◽

Poor Quality ◽

Normal Weight ◽

Type Ii ◽

Asthma Control Questionnaire ◽

Cross Sectional ◽

Oral Corticosteroids

Both severe asthma and obesity are growing health problems. Severe asthma leads to a poor quality of life. The relationship among BMI, comorbidities, and severe asthma control in adults is still unclear. The aim of the study is to better understand the effect of the comorbidities as atopy, type II diabetes, OSAS, gastroesophageal reflux, hypertension, cardiovascular diseases, osteoporosis, infections, and psychological factors with BMI on asthma control in a cohort of adult severe asthmatics. One hundred and two patients were enrolled in a cross-sectional study assessing asthma control, treatments, pulmonary function, inflammatory markers, and comorbidities. Patients were divided into 3 classes according to BMI: normal weight, overweight, and obese. We found that the optimal state of asthma control is lower. whereas the score of Asthma Control Questionnaire, the number of asthma exacerbations during last year, the oral corticosteroids requirement during the previous year, and the LABA treatments are higher in obese than in overweight and normal weight severe asthmatics. The number of subjects with type II diabetes and OSAS are higher among obese and overweight patients than in normal weight asthmatics. In conclusion, BMI representsper sea factor for the deterioration in disease control in severe asthma.

Download Full-text

P107 The impact of anti-IL5/5R biologic therapies on specific domains of the Asthma Control Questionnaire

10.1136/thorax-2020-btsabstracts.252 ◽

2021 ◽

Author(s):

E Rykova ◽

AP Hearn ◽

J Kavanagh ◽

G d’Ancona ◽

M Fernandes ◽

...

Keyword(s):

Asthma Control ◽

Biologic Therapies ◽

Asthma Control Questionnaire ◽

The Impact

Download Full-text

Lessons learned from clinical trials of asthma

Allergy and Asthma Proceedings ◽

10.2500/aap.2019.40.4259 ◽

2019 ◽

Vol 40 (6) ◽

pp. 410-413

Author(s):

Paul A. Greenberger

Keyword(s):

Asthma Control ◽

Severe Asthma ◽

Immunoglobulin E ◽

Environmental Control ◽

Mild Asthma ◽

Inhaled Corticosteroid ◽

Biologic Therapies ◽

Asthma Control Questionnaire ◽

Exacerbation Rate ◽

Sputum Eosinophilia

Exacerbations of persistent or intermittent asthma should be anticipated by physicians and health-care professionals. Patients who are likely to experience an exacerbation often have a history of an exacerbation in the previous year, and the absolute eosinophil count in peripheral blood is ≥ 400/μL. Similarly, expectorated or induced sputum eosinophilia of ≥2% is associated with exacerbations. These phenotypic findings have led to effective biologic therapies, which target eosinophils or immunoglobulin E or the T-helper type 2 phenotype, especially in children, adolescents, and adults with frequent exacerbations. In children, a reduced forced expiratory volume in the first second of expiration (FEV1) to forced vital capacity ratio can be associated with future exacerbations, although the FEV1 may be in the normal range, even with children who have persistent severe asthma. Asthma control questionnaires did not differentiate between children with or children without a future exacerbation. Alternatively, in adults, the lower baseline FEV1 (2.3 L [74% predicted] versus 2.5 L [78% predicted]) identified patients more likely to have a future exacerbation compared with patients who were not having an exacerbation. After correcting for FEV1, the asthma control questionnaire data were associated with exacerbations. In adolescents (ages ≥ 12 years) and adults with persistent mild asthma, most (73%) did not have sputum eosinophilia, and some of these patients responded well to the anticholinergic, tiotropium, which would argue differently from administration of an inhaled corticosteroid as first-line controller therapy. In a three-track study of patients with persistent mild asthma, as-needed budesonide-formoterol and scheduled budesonide were associated with approximately one-half of the annual exacerbation rate of as-needed albuterol. In patients with persistent moderate-to-severe asthma, tiotropium added to controller therapy caused an increase in FEV1 without improving the asthma control questionnaire findings. There were two studies that explored whether either quadrupling or quintupling the inhaled corticosteroid at the first sign of loss of control of asthma would provide meaningful reductions of severe exacerbations of asthma, but the findings did not support this strategy. Both biologic therapies and environmental control (dust mite impermeable encasings) have resulted in reductions of exacerbations in patients with persistent moderate and severe asthma.

Download Full-text

The Asthma Control Questionnaire as a clinical trial endpoint: past experience and recommendations for future use

Allergy ◽

10.1111/all.12415 ◽

2014 ◽

Vol 69 (9) ◽

pp. 1119-1140 ◽

Cited By ~ 12

Author(s):

P. J. Barnes ◽

T. B. Casale ◽

R. Dahl ◽

I. D. Pavord ◽

M. E. Wechsler

Keyword(s):

Clinical Trial ◽

Asthma Control ◽

Past Experience ◽

Asthma Control Questionnaire ◽

Clinical Trial Endpoint ◽

Trial Endpoint

Download Full-text

P230 Does the global asthma visual analogue scale relate to the asthma control questionnaire?

10.1136/thoraxjnl-2017-210983.372 ◽

2017 ◽

Author(s):

S Jabbal ◽

B Lipworth

Keyword(s):

Visual Analogue Scale ◽

Asthma Control ◽

Analogue Scale ◽

Asthma Control Questionnaire

Download Full-text

Factors related to the incorrect use of inhalers by asthma patients

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37132014000100003 ◽

2014 ◽

Vol 40 (1) ◽

pp. 13-20 ◽

Cited By ~ 19

Author(s):

Paulo de Tarso Roth Dalcin ◽

Denis Maltz Grutcki ◽

Paola Paganella Laporte ◽

Paula Borges de Lima ◽

Samuel Millan Menegotto ◽

...

Keyword(s):

Asthma Control ◽

Family Income ◽

Pulmonary Function Tests ◽

Cross Sectional Study ◽

Inhaler Technique ◽

Metered Dose Inhalers ◽

Porto Alegre ◽

Asthma Control Questionnaire ◽

Cross Sectional ◽

Metered Dose

OBJECTIVE: To evaluate inhaler technique in outpatients with asthma and to determine associations between the correctness of that technique and the level of asthma control. METHODS: This was a cross-sectional study involving patients > 14 years of age with physician-diagnosed asthma. The patients were recruited from the Asthma Outpatient Clinic of the Hospital de Clínicas de Porto Alegre, in the city of Porto Alegre, Brazil. The patients completed two questionnaires (a general questionnaire and an asthma control questionnaire based on the 2011 Global Initiative for Asthma guidelines), demonstrated their inhaler technique, and performed pulmonary function tests. Incorrect inhaler technique was defined as the incorrect execution of at least two of the predefined steps. RESULTS: We included 268 patients. Of those, 81 (30.2%) showed incorrect inhaler technique, which was associated with poor asthma control (p = 0.002). Logistic regression analysis identified the following factors associated with incorrect inhaler technique: being widowed (OR = 5.01; 95% CI, 1.74-14.41; p = 0.003); using metered dose inhalers (OR = 1.58; 95% CI, 1.35-1.85; p < 0.001); having a monthly family income < 3 times the minimum wage (OR = 2.67; 95% CI, 1.35-1.85; p = 0.008), and having > 2 comorbidities (OR = 3.80; 95% CI, 1.03-14.02; p = 0.045). CONCLUSIONS: In the sample studied, incorrect inhaler technique was associated with poor asthma control. Widowhood, use of metered dose inhalers, low socioeconomic level, and the presence of > 2 comorbidities were associated with incorrect inhaler technique.

Download Full-text