Magnitude of effect of asthma treatments on Asthma Quality of Life Questionnaire and Asthma Control Questionnaire scores: Systematic review and network meta-analysis

Abstract

The established within-patient MID for the ACQ and AQLQ is not achievable as a group-wise efficacy threshold between treatment arms in clinical studies in which controllers are added to ICS treatment. Thus in addition to reporting mean changes of the instruments, other measurement criteria should be considered, including responder analyses.

Tiotropium add-on therapy in adolescents with moderate asthma: A 1-year randomized controlled trial

“…[27][28][29] It is likely that patients became more adherent to background ICS therapy during the course of the trial, a well-known phenomenon in clinical trials in this age group. 26 The results of our study add to the body of evidence that supports the inclusion of tiotropium as an option in the stepwise addition of treatment for uncontrolled asthma in adolescents. According to current guidelines, the addition of a LABA should be considered in adolescent patients with mild or moderate asthma not fully controlled by ICS monotherapy, with a higher dose of ICS or the addition of an LTRA as acceptable alternatives.…”

“…Improvements in ACQ-6, ACQ-7, and AQLQ(S)112 scores were observed but were not statistically significant compared with those in patients receiving placebo; however, the study was not powered for these end points. Furthermore, in a network analysis of results from a large number of asthma trials in which ACQ and AQLQ scores were assessed, Bateman et al 26 reported that the minimal clinically important difference (expressed as mean improvements between treatment arms) is seldom achieved and unlikely in studies like ours, in which a second or third controller is added in combination with ICSs. A limitation of our study might be the relatively large response observed in the placebo group.…”

Patient Satisfaction and Clinical Outcomes with Budesonide plus Formoterol Spiromax for Asthma and Chronic Obstructive Pulmonary Disease: A Real-World, Observational Trial

“…ICS/LABA combination therapy results in improved lung function and control of symptoms compared with monotherapy with either drug [3-5]. As such, these two classes of drugs are now available in several fixed-dose combinations.…”

Roflumilast combined with montelukast versus montelukast alone as add-on treatment in patients with moderate-to-severe asthma

“…At study's end, although not statistically significant between treatments, the mean overall improvement (reduction) in ACQ-7 score from baseline in patients receiving montelukast plus roflumilast in period 2 almost achieved the minimal clinically important difference for an ACQ-7 score of 0.5, a surprising result given the difficulty of achieving this in studies of add-on therapy in asthmatic patients. 24 A post hoc responder analysis confirmed a decrease of 0.5 or greater in ACQ-7 score in only 1 of the 2 treatment periods with roflumilast plus montelukast (15 patients) compared with 8 patients receiving placebo plus montelukast. Reliever medication use was also lower while patients were taking roflumilast plus montelukast than while taking placebo plus montelukast.…”