Impact of Clinical Characteristics and Biomarkers on Asthma Impairment and Risk Questionnaire Exacerbation Prediction Ability.

Background: Complex models combining impairment-based control assessments with clinical characteristics and biomarkers have been developed to predict asthma exacerbations. The composite Asthma Impairment and Risk Questionnaire (AIRQ) with adjustments for demographics (age, sex, race, and body mass index) predicts 12-month exacerbation occurrence similarly to these more complex models.

Objective: To examine whether AIRQ exacerbation prediction is enhanced when models are adjusted for a wider range of clinical characteristics and biomarkers.

Advancing assessment of asthma control with a composite tool: The Asthma Impairment and Risk Questionnaire.

Background: National and international asthma guidelines and reports do not include control tools that combine impairment assessment with exacerbation history in one instrument.

Objective: To analyze the performance of the composite Asthma Impairment and Risk Questionnaire (AIRQ) in assessing both domains of control and predicting exacerbation risk compared with the Global Initiative for Asthma (GINA) 4-question symptom control tool (GINA SCT), Asthma Control Test (ACT), and physician expert opinion (EO) informed by GINA SCT responses and appraisal of GINA-identified risk factors for poor asthma outcomes.

Methods: Multivariable logistic regressions evaluated AIRQ and GINA SCT as predictors of ACT.

Assessing meaningful change in the Asthma Impairment and Risk Questionnaire.

Background: The Asthma Impairment and Risk Questionnaire (AIRQ) is a 10-item, yes/no, equally weighted control tool. Lower scores indicate better control. Moreover, 7 impairment items reflect previous 2-week symptoms, and 3 risk items assess previous 12-month exacerbations.

The Asthma Impairment and Risk Questionnaire enhances the assessment of asthma control.

Background: Asthma control is often overestimated in routine practice, and despite advances in the understanding of immunopathology and the availability of new precision therapies, the burden of disease remains unacceptably high.

Objective: To compare the performance of the Asthma Impairment and Risk Questionnaire (AIRQ) with patient and physician assessments and the Asthma Control Test (ACT) in identifying asthma control.

Methods: Baseline data from a longitudinal study of the AIRQ were analyzed.

Relationship Between Asthma Control as Measured by the Asthma Impairment and Risk Questionnaire (AIRQ) and Patient Perception of Disease Status, Health-Related Quality of Life, and Treatment Adherence.

Purpose: Critical asthma outcomes highlighted in clinical guidelines include asthma-related quality of life, asthma exacerbations, and asthma control. An easy-to-implement measure of asthma control that assesses both symptom impairment and exacerbation risk and reflects the impact of asthma on patients' lives is lacking. Hence, the objective of this study was to assess the Asthma Impairment and Risk Questionnaire (AIRQ) construct validity relative to patient self-perception of asthma status and validated disease-specific patient-reported outcome (PRO) measures.

The Asthma Impairment and Risk Questionnaire (AIRQ) Control Level Predicts Future Risk of Asthma Exacerbations.

Background: The Asthma Impairment and Risk Questionnaire (AIRQ) is a 10-item, equally weighted, yes/no control tool validated in patients with asthma aged 12 years and older.

Objective: To evaluate AIRQ's ability to predict patient-reported exacerbations over 12 months.

Methods: Patients completed a baseline AIRQ during an in-person enrollment visit and reported exacerbations (ie, asthma-related courses of oral corticosteroids, emergency department/urgent care visits, and hospitalizations) via monthly online surveys.

Evaluating construct validity of the Asthma Impairment and Risk Questionnaire using a 3-month exacerbation recall.

Background: Recurrent assessment of asthma control is essential to evaluating disease stability and intervention impacts. An assessment that can be administered between annual clinic visits is needed. The Asthma Impairment and Risk Questionnaire (AIRQ) is a cross-sectionally validated, 10-item, yes or no, composite control tool evaluating previous 2-week symptoms and previous 12-month exacerbations.

Development of the Asthma Impairment and Risk Questionnaire (AIRQ): A Composite Control Measure.

Background: Asthma exacerbation risk increases with worsening asthma control. Prevailing numerical control tools evaluate only current symptom impairment despite the importance of also assessing risk based on exacerbation history. An easy-to-use questionnaire addressing impairment and risk domains of control is needed.

An official American Thoracic Society Workshop report: obesity and asthma.

Rationale: The developed world is currently facing an epidemic of obesity. With the increased prevalence of obesity has come the recognition that obesity is a risk factor for asthma.

Objectives: The purpose of this workshop was to bring together experts in the field of asthma, with experts in the field of obesity to review the current state-of-the-art knowledge regarding obesity and asthma, with the goal of furthering our understanding of the link between these two disease entities to help define important future directions for research.

Update on infection and antibiotics in asthma.

Asthma pathogenesis seems to be a result of a complex mixture of genetic and environmental influences. There is evidence that Mycoplasma pneumoniae and Chlamydophila pneumoniae (formerly known as Chlamydia pneumoniae) play a role in promoting airway inflammation that could contribute to the onset and clinical course of asthma. Evidence also indicates that when antimicrobial therapy can eradicate or suppress these organisms, it may be possible to alter the course of the disease.

Recent insight into obesity and asthma.

Purpose Of Review: The worldwide pandemic of obesity is creating unique challenges for the diagnosis and treatment of asthma. A wealth of epidemiologic literature has established that whereas asthma can lead to obesity, obesity is a risk factor for asthma, but mechanisms are unclear. This review assesses the current understanding of the relationship between obesity and asthma.

Obesity and asthma.

Population-based studies have defined a significant, bidirectional, dose-dependent association between obesity and asthma. Obesity does not cause airflow obstruction, but can result in pulmonary restriction and a reduction in airway diameter, and that could contribute to airway hyper-responsiveness. Mouse models of asthma have demonstrated that obesity and adipokines can enhance airway hyper-responsiveness, airway inflammation, and allergic responses, but it is unclear whether obesity-associated inflammatory mechanisms are relevant in human asthma.

Hypoventilation in asthma and chronic obstructive pulmonary disease.

Chronic hypoventilation is a marker of disease severity in asthma and chronic obstructive pulmonary disease (COPD). The degree to which this predicts severity or objective measures of lung function is variable, and more reliable for COPD than for asthma. Patients with COPD are particularly susceptible to nocturnal hypoventilation, but at-risk patients can be identified by abnormalities in daytime gas exchange.

Body mass and glucocorticoid response in asthma.

Rationale: Obesity may alter glucocorticoid response in asthma.

Objectives: To evaluate the relationship between body mass index (BMI, kg/m(2)) and glucocorticoid response in subjects with and without asthma.

Methods: Nonsmoking adult subjects underwent characterization of lung function, BMI, and spirometric response to prednisone.

Overweight, obesity, and incident asthma: a meta-analysis of prospective epidemiologic studies.

Rationale: Although obesity has been implicated as an asthma risk factor, there is heterogeneity in the published literature regarding its role in asthma incidence, particularly in men.

Objectives: To quantify the relationship between categories of body mass index (BMI) and incident asthma in adults and to evaluate the impact of sex on this relationship.

Methods: Online bibliographic databases were searched for prospective studies evaluating BMI and incident asthma in adults.

Efficacy of a heat exchanger mask in cold exercise-induced asthma.

Study Objectives: To determine the efficacy of a novel mask device in limiting cold air exercise-induced decline in lung function in subjects with a history of exercise-induced asthma (EIA).

Setting: In spite of appropriate medical therapy, many asthma patients are limited in cold weather activities.

Design: In study 1, 13 asthmatic subjects performed two randomized, single-blind treadmill exercise tests while breathing cold air (- 25 to - 15 degrees C) through a placebo or active heat exchanger mask.

Obesity and asthma.

Asthma and obesity are prevalent disorders, each with a significant public health impact, and a large and growing body of literature suggests an association between the two. The systemic inflammatory milieu in obesity leads to metabolic and cardiovascular complications, but whether this environment alters asthma risk or phenotype is not yet known. Animal experiments have evaluated the effects of leptin and obesity on airway inflammation in response to both allergic and nonallergic exposures and suggest that airway inflammatory response is enhanced by both endogenous and exogenous leptin.

Antibiotics in asthma.

Asthma pathogenesis appears to be a result of a complex mixture of genetic and environmental influences. There is evidence that Mycoplasma pneumoniae and Chlamydia pneumoniae play a role in promoting airway inflammation that could contribute to the onset and clinical course of asthma. If antimicrobial therapy can eradicate these organisms, it might be possible to alter the course of the disease.