Use of the Asthma Control Questionnaire to predict future risk of asthma exacerbation
Use of the Asthma Control Questionnaire to predict future risk of asthma exacerbation
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DOI：
10.1016/j.jaci.2010.08.042
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发表时间：
2011-01-01
影响因子：
14.2
通讯作者：
Lin, Shao-Lee
中科院分区：
文献类型：
--
作者：
Meltzer, Eli O.;Busse, William W.;Lin, Shao-Lee
背景：哮喘控制问卷 (ACQ) 等经过验证的综合指标评估与哮喘恶化风险之间的直接相关性尚未在随机对照试验中得到证实。目的：评估 ACQ 评分随时间推移预测未来哮喘恶化风险的能力。方法：该分析包括 AMG 317（一种 IL-4 受体 α 拮抗剂）为期 12 周的安慰剂对照试验 (N = 292) 的数据。中度至重度特应性哮喘患者。基线时，患者的 ACQ 评分 >= 1.5。恶化被定义为需要全身性皮质类固醇。使用 Cox 比例风险模型，以 ACQ 评分作为时间依赖性协变量。对 ACQ 的各个组成部分重复进行分析。结果：ACQ 每增加 1 点，接下来 2 周期间的病情恶化风险就会增加 50%（风险比，1.50；95% CI，1.03-2.20）。对各个 ACQ 组成部分的评估也表现出类似的趋势，尽管每个组成部分的程度均低于完整的复合 ACQ。结论：虽然基于回顾性分析，且急性加重次数较少，但这些发现支持综合 ACQ 评分测量在临床试验和临床实践中预测未来加重风险的实用性。研究发现，与单独的 ACQ 组成部分相比，综合 ACQ 评分测量能够更好地预测未来风险。 （过敏临床免疫杂志 2011 年；127：167-72。）
Background: Direct correlation of assessments of a validated composite measure such as the Asthma Control Questionnaire (ACQ) and risk of exacerbation has not been previously demonstrated in a randomized controlled trial.Objective: To evaluate the ability of the ACQ score over time to predict risk of a future asthma exacerbation.Methods: This analysis included data from a 12-week placebo-controlled trial (N = 292) of AMG 317, an IL-4 receptor alpha antagonist, in patients with moderate to severe atopic asthma. At baseline, patients had an ACQ score >= 1.5. Exacerbations were defined as requirement for systemic corticosteroids. A Cox proportional hazards model was used, with ACQ score as the time-dependent covariate. The analysis was repeated for individual components of the ACQ.Results: Each 1-point increase in ACQ was associated with a 50% increased risk of exacerbation (hazard ratio, 1.50; 95% CI, 1.03-2.20) for the following 2-week period. Evaluation of individual ACQ components also demonstrated a similar trend, though each to a lesser degree than the full composite ACQ.Conclusion: Although based on a retrospective analysis, with small number of exacerbations, these findings support the utility of the composite ACQ score measurement to predict risk of future exacerbation in clinical trials and clinical practice. The composite ACQ score measurement was found to be a better predictor of future risk than individual ACQ components. (J Allergy Clin Immunol 2011;127:167-72.)