采用哮喘控制问卷调查来预测哮喘加重风险
2011/03/24
摘要
背景：有关有效综合检测评价[如：哮喘控制问卷调查（ACQ）]与哮喘恶化的直接相关性，前期尚未在随机对照试验中进行研究。
目的：评价随着时间变化的ACQ评分是否可用于未来哮喘恶化风险的预测。
方法：本研究数据来自于为期12周的安慰剂-对照试验(N = 292)，该试验在中度至重度过敏性哮喘患者中研究IL-4受体α拮抗剂（AMG 317）。在基线状态下，患者的ACQ评分≥1.5。哮喘恶化定义为需要采用全身皮质激素治疗。将ACQ评分作为一个时间依赖性协变量，采用Cox比例风险模型进行分析。对ACQ的各组成采用该模型进行重复分析。
结果：ACQ评分每增加1分，与随后2周内哮喘恶化风险增加50%相关（危险比1.50; 95% CI, 1.03-2.20）。对ACQ各组成的评价也显示同样的趋势，但是与ACQ总体评分相比，风险程度增加稍低。
结论：基于回顾性分析，虽然样本量较小，但是这些结果支持采用综合ACQ评分来预测临床试验和临床实践中未来哮喘恶化的风险。与ACQ各组成部分相比，综合ACQ评分是更好的哮喘恶化风险预测指标。
（陈欣 审校）
J Allergy Clin Immunol. 2010 Nov 17. [Epub ahead of print]
Use of the asthma control questionnaire to predict future risk of asthma exacerbation.
Meltzer EO, Busse WW, Wenzel SE, Belozeroff V, Weng HH, Feng J, Chon Y, Chiou CF, Globe D, Lin SL.
Allergy and Asthma Medical Group and Research Center, San Diego, Calif.
Abstract
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 α 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. 2010 Nov 17. [Epub ahead of print]
背景：有关有效综合检测评价[如：哮喘控制问卷调查（ACQ）]与哮喘恶化的直接相关性，前期尚未在随机对照试验中进行研究。
目的：评价随着时间变化的ACQ评分是否可用于未来哮喘恶化风险的预测。
方法：本研究数据来自于为期12周的安慰剂-对照试验(N = 292)，该试验在中度至重度过敏性哮喘患者中研究IL-4受体α拮抗剂（AMG 317）。在基线状态下，患者的ACQ评分≥1.5。哮喘恶化定义为需要采用全身皮质激素治疗。将ACQ评分作为一个时间依赖性协变量，采用Cox比例风险模型进行分析。对ACQ的各组成采用该模型进行重复分析。
结果：ACQ评分每增加1分，与随后2周内哮喘恶化风险增加50%相关（危险比1.50; 95% CI, 1.03-2.20）。对ACQ各组成的评价也显示同样的趋势，但是与ACQ总体评分相比，风险程度增加稍低。
结论：基于回顾性分析，虽然样本量较小，但是这些结果支持采用综合ACQ评分来预测临床试验和临床实践中未来哮喘恶化的风险。与ACQ各组成部分相比，综合ACQ评分是更好的哮喘恶化风险预测指标。
（陈欣 审校）
J Allergy Clin Immunol. 2010 Nov 17. [Epub ahead of print]
Use of the asthma control questionnaire to predict future risk of asthma exacerbation.
Meltzer EO, Busse WW, Wenzel SE, Belozeroff V, Weng HH, Feng J, Chon Y, Chiou CF, Globe D, Lin SL.
Allergy and Asthma Medical Group and Research Center, San Diego, Calif.
Abstract
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 α 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. 2010 Nov 17. [Epub ahead of print]
