Asthma and lower airway diseaseUse of the Asthma Control Questionnaire to predict future risk of asthma exacerbation
Section snippets
Patients
A post hoc analysis of data from a 12-week multicenter, double-blind, randomized, placebo-controlled clinical trial16 was conducted to assess the association between the ACQ and asthma exacerbation. Patients with moderate to severe atopic asthma were enrolled in a dose-ranging phase 2 study to assess the safety and efficacy of AMG 317, an IL-4 receptor α antagonist. Patients were randomly assigned in a 1:1:1:1 ratio to receive 1 of 3 doses of the IL-4 receptor α antagonist or placebo
Patients
A total of 292 patients with moderate to severe asthma were included in the analysis. The study population was 71% white, 18% black, 58% women, and had a mean age of 41 years (Table I). At baseline, patients had a mean FEV1 of 68.3% and mean ACQ score of 2.54. Baseline characteristics were similar between patients with and without an exacerbation. All baseline characteristics were considered for the final model; none were determined as potential confounders relative to exacerbations.
ACQ and exacerbations
Asthma
Discussion
In this retrospective analysis of data from a randomized clinical trial, asthma control as measured by the ACQ composite score was found to be significantly associated with the risk of future exacerbation. This finding was confirmed with the analysis demonstrating consistently higher odds of having an exacerbation with an increase in the proximate ACQ score. A direct correlation between sequential measurements of ACQ, an indicator of asthma impairment, and the risk of future exacerbation, as
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2023, Journal of Allergy and Clinical ImmunologyCitation Excerpt :Indeed, by 12 weeks, the lower 95% CI exceeded twice the MCID at >1.0. These findings are especially clinically relevant because it has previously been determined that each 1.0-unit increase in ACQ is associated with an approximately 50% increased risk of asthma exacerbation.17 For mini-AQLQ scores, the lower 95% CIs exceeded 0.5 at 2, 4, 8, and 12 weeks (Fig 2).
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2021, Journal of Allergy and Clinical Immunology: In PracticeCitation Excerpt :We did not include the ACQ score in the analysis because of the high number of missing values (37%) and did not include it in the sensitivity analysis owing to collinearity with asthma control (GINA). Meltzer et al54 found that the ACQ score correlated with an increased risk for future exacerbations. It is therefore possible that inclusion of the EPDS score and ACQ would result in a better model if the number of observations were higher.
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Supported by Amgen Inc.
Trial registration: This study is registered with ClinicalTrials.gov with the identifier NCT 00436670.
Disclosure of potential conflict of interest: E. O. Meltzer has received research support from UCB, Alcon, Alexza, Amgen, Antigen Labs, Apotex, Astellas, AstraZeneca, Boehringer Ingelheim, Capnia, Critical Therapeutics, GlaxoSmithKline, MAP, MEDA, Merck, Novartis, Proctor & Gamble, Schering-Plough, and Teva; has served as a consultant or on an advisory board for Schering Plough, Alcon, Alexza Pharmaceuticals, Amgen, AstraZeneca, Boehringer Ingelheim, Capnia, Dainippon Sumitomo Pharma, Dey, ISTA, Johnson & Johnson, Kalypsys, MAP, Meda, Merck, National Jewish Health, Rady Children's Hospital San Diego, Sandoz, Sepracor, SRxA, Teva, VentiRx, Wockhardt, and Wyeth; is a speaker for GlaxoSmithKline, MEDA, Merck, Sanofi-Aventis, Schering-Plough, Sepracor, and SRxA; has served as an expert in legal matters on the topics of desloratadine, fexofenadine, montelukast, and levocetirizine; and is a fellow for the AAAAI and the American College of Allergy, Asthma and Immunology. W. W. Busse is on the advisory board for Altair, GlaxoSmithKline, Merck, Wyeth, Pfizer Centocor, Amgen, and Johnson & Johnson; is a speaker for Merck; is a consultant for Novartis, Astra Zeneca, TEVA, Boehringer Ingelhim, and GlaxoSmith-Kline; and has received research support from NIH-NIAID, NIH-NHLBI, Novartis, AstraZeneca, GlazoSmithKline, MedImmune, and Ception. S. E. Wenzel is a consultant for GlaxoSmithKline, Merck, Amgen, and Pearl Therapeutics; is on the advisory board for Amira, Altair, and Epigenesis; and has received research support from GlaxoSmithKline, Amgen, and MedImmune. V. Belozeroff, H. H. Weng, D. Globe, and S.-L. Lin are employed by Amgen. Y. Chon holds stock in Amgen. The rest of the authors have declared that they have no conflict of interest.