The authors of this Merck-sponsored study aimed to develop a weighted and responsive measure of asthma disease activity. They used 2 previously conducted clinical trials to develop the Asthma Disease Activity Score (ADAS-6).
The ADAS-6 assessed 6 different manifestations of asthma:
- FEV(1) (percent predicted)
- Asthma Quality of Life Questionnaire-Symptom domain
- rescue beta-agonist use
- nocturnal awakenings
- peak expiratory flow diurnal variability
- rescue beta-agonist use diurnal variability
The ADAS-6 distinguished levels of disease activity and response to different treatment intensities (P less than 0.0001). In particular, ADAS-6 was highly responsive to treatment effects. Using ADAS-6 as the primary end point could reduce the sample size needed to detect a change in outcome in clinical trials. Increments in the ADAS-6 predicted the risk of future asthma attacks. A simplified Asthma Disease Activity Score 4-variable version (ADAS-4) demonstrated similar properties.
The authors concluded that ADAS-6 and ADAS-4 are new measures of asthma disease activity that might better separate treatment effects, predict future asthma attacks, and reduce sample size.
Editor’s note: The findings of this pharmaceutical company-sponsored and authored publication are promising but they need an independent confirmation.
The asthma disease activity score: a discriminating, responsive measure predicts future asthma attacks. Greenberg S, Liu N, Kaur A, Lakshminarayanan M, Zhou Y, Nelsen L, Gates DF Jr, Kuo WL, Smugar SS, Reiss TF, Barnes N, Fuhlbrigge A, Milgrom H, Schatz M, Knorr B. J Allergy Clin Immunol. 2012 Nov;130(5):1071-1077.e10. doi: 10.1016/j.jaci.2012.07.057. Epub 2012 Oct 1.