PT - JOURNAL ARTICLE AU - J. Zhang AU - C. Yu AU - S.T. Holgate AU - T.F. Reiss TI - Variability and lack of predictive ability of asthma end-points in clinical trials AID - 10.1183/09031936.02.02402001 DP - 2002 Nov 01 TA - European Respiratory Journal PG - 1102--1109 VI - 20 IP - 5 4099 - http://erj.ersjournals.com/content/20/5/1102.short 4100 - http://erj.ersjournals.com/content/20/5/1102.full SO - Eur Respir J2002 Nov 01; 20 AB - While a consensus definition of the clinical parameters important in asthma control exists, an adequate objective definition of a response to asthma treatment and parameters for prediction of that response remain undefined. Given that asthma is a complex biological disease and that different parameters may measure dissimilar aspects of the disease status, this study assessed the relationship among several end-points of asthma control, and attempted to select a combination of variables measured before (baseline characteristics) or early in asthma therapy which would be predictive of a long-term clinical response. Data from two previously reported clinical studies which included montelukast, inhaled beclomethasone, and placebo in mild-to-moderate asthmatics (n=1,576) were analysed. The forced expiratory volume in one second (FEV1), daily symptoms score (DSS), β-agonist use, and morning peak expiratory flow (PEFAM) were recorded during the baseline period and throughout the 12-week treatment period. For the long-term response, as measured during the last 9 weeks of treatment, there was a large within-patient variability and no more than a moderate correlation between the changes in FEV1 and PEFAM; DSS and FEV1; and DSS and β-agonist use. The overall predictive values for FEV1 and DSS were 70–80%. The results showed that multiple measurements over a length of time are needed to establish a more complete profile of response, and that demographic and early treatment responses had a small but inadequate ability to predict future response. This study demonstrates the complex relationship among asthma end-points and the difficulty of reliably estimating long-term response using common, surrogate clinical markers of asthma control. This study was supported by a grant from the Merck Research Laboratories.