Asthma control and quality of life in a real-life setting: a cross-sectional study of adult asthma patients in Japan (ACQUIRE-2)

Figures & data

Table 1. Criteria for level of asthma control (adapted from JGL 2015 and GINA 2012).

	Level of asthma control (modified from JGL 2015) [8]
	Well-controlled (Meet all criteria)	Insufficiently-controlled (Meet 1 or 2 criteria)	Poorly-controlled
Asthma symptoms (in the daytime or at night)	None	Once or more a week	Met 3 or more criteria of insufficiently-controlled
Use of reliever	None	Once or more a week
Limitation of activities including exercise	None	Restricted
Exacerbation^a	None	Once or more a year	Once or more a month
	Level of asthma control (modified from GINA 2012) [15]
	Controlled (All of the following)	Partly controlled (Any measure presented)	Uncontrolled
Daytime symptoms	None (twice or less/week)	More than twice/week	Three or more features of “partly controlled asthma”
Limitation of activities	Absent	Present
Nocturnal symptoms/awaking	Absent	Present
Need for reliever/rescue inhaler	None (twice or less/week)	More than twice/week
Exacerbation^b	Absent	Absent	More than once in four weeks

^a Exacerbation was determined based on the clinical record within the past 1 year and the patient diary (recorded for 7 consecutive days).

^b Exacerbations recorded within the previous 4 weeks or the 7 consecutive days in the patient diary were classified as uncontrolled asthma.

JGL: Asthma Prevention and Management Guideline, Japan; GINA: Global Initiative for Asthma.

Figure 1. Patient disposition.

Table 2. Patient demographic and clinical characteristics.

Patient demographic or clinical characteristic		No. of patients (%) or mean ± SD
Overall		1175 (100.0)
Sex
	Male	436 (37.1)
	Female	739 (62.9)
Age, years		n = 1175
		59.7 ± 14.5
BMI, kg/m^2		n = 1163
		23.4 ± 3.9
Smoking status
	Never smoker	760 (64.7)
	Ex-smoker	358 (30.5)
	Current smoker	57 (4.9)
Smoking history, pack years		n = 415
		25.1 ± 23.2
Duration of asthma, years		n = 1001
		16.9 ± 14.0
History of childhood asthma
	Yes	204 (17.4)
	No	821 (69.9)
	Unknown	150 (12.8)
Family history of asthma
	Yes	262 (22.3)
	No	606 (51.6)
	Unknown	307 (26.1)
Use of controller during the past 1 year		1168 (99.4)
Medications at the time of consent
	ICS or ICS/LABA	1163 (99.0)
	LTRA	486 (41.4)
	Antiallergic agents	269 (22.9)
	Theophylline	232 (19.7)
	Short-acting β2 agonist	197 (16.8)
	Systemic corticosteroids	118 (10.0)
	LAMA	102 (8.7)
	LABA (single agent)	47 (4.0)
	Anti-IgE antibody	24 (2.0)
History of exacerbation in the year prior to enrollment
	Yes	213 (18.1)
	No	962 (81.9)
Comorbidity
	Yes	888 (75.6)
	No	287 (24.4)
Type of comorbidity
	Rhinitis allergic/pollinosis	534 (45.4)
	Gastroesophageal reflux	99 (8.4)
	Chronic sinusitis	85 (7.2)
	Chronic obstructive pulmonary disease	66 (5.6)
	Atopic dermatitis	55 (4.7)
	NSAID sensitive asthma	40 (3.4)
	Food allergy	37 (3.1)
	Eosinophilic sinusitis	23 (2.0)
	Cardiac failure	11 (0.9)
	Eosinophilic otitis media	9 (0.8)
	Eosinophilic granulomatosis with polyangiitis/Churg–Strauss syndrome/allergic granulomatous angiitis	6 (0.5)
	Allergic bronchopulmonary mycosis	6 (0.5)
	Other concomitant conditions not listed above	528 (44.9)

BMI: body mass index; ICS: inhaled corticosteroid; LABA: long-acting β2 agonist; LAMA: long-acting anticholinergic agent; LTRA: leukotriene receptor antagonist; NSAID: nonsteroidal anti-inflammatory drug; SD: standard deviation.

Table 3. Summary of clinical test results.

Clinical test		No. of patients (%) or mean ± SD
Overall		1175 (100.0)
Lung function		n = 578
	FVC (L)	2.909 ± 0.881
	FEV1 (L)	2.113 ± 0.748
	FEV1/FVC (%)	72.4 ± 11.9
	FEV1 % predicted	85.3 ± 20.2
	Peak expiratory flow rate (L/s)	5.958 ± 2.108
Reversibility		n = 122
	FEV1 reversibility (mL)	107.2 ± 128.6
	Rate of change (%)	6.5 ± 9.3
Fractional exhaled nitric oxide		n = 335
	Overall (ppb)	33.8 ± 29.4
Eosinophils in peripheral blood		n = 262
	Eosinophil ratio (%)	4.8 ± 4.9
	Eosinophils in peripheral blood (cells/μL)	318.2 ± 366.8
Total IgE level (IU/mL)		n = 132
		388.7 ± 692.5
Specific IgE antibodies		n = 52
	Negative	13 (1.1)
	Positive	39 (3.3)

FEV₁: forced expiratory volume in 1 s; FVC: forced vital capacity; SD: standard deviation.

Table 4. Level of asthma control.

		JGL 2015-based criteria
		Total	Well-controlled n (%)	Insufficiently-controlled n (%)	Poorly-controlled n (%)
Overall		992	242 (24.4)	686 (69.2)	64 (6.5)
Treatment step (by JGL)
	1	67	37 (55.2)	29 (43.3)	1 (1.5)
	2	273	93 (34.1)	168 (61.5)	12 (4.4)
	3	449	90 (20.0)	334 (74.4)	25 (5.6)
	4	201	22 (10.9)	153 (76.1)	26 (12.9)
	Unknown	2	–	–	–
		GINA 2012-based criteria
		Total	Controlled n (%)	Partly controlled n (%)	Uncontrolled n (%)
Overall		992	348 (35.1)	494 (49.8)	150 (15.1)
Treatment step (by GINA)
	1	0	0	0	0
	2	60	38 (63.3)	20 (33.3)	2 (3.3)
	3	315	144 (45.7)	141 (44.8)	30 (9.5)
	4	554	147 (26.5)	308 (55.6)	99 (17.9)
	5	54	15 (27.8)	21 (38.9)	18 (33.3)
	Unknown	9	–	–	–

JGL: Asthma Prevention and Management Guideline 2015, Japan; GINA: Global Initiative for Asthma 2012.

Table 5. Asthma symptoms.

Asthma symptoms, n (%)			n = 992*
Any asthma symptoms
		Daytime	511 (51.5)
		Nighttime	445 (44.9)
Wheezing
		Daytime	162 (16.3)
		Nighttime	159 (16.0)
Chest tightness
		Daytime	209 (21.1)
		Nighttime	158 (15.9)
Cough
		Daytime	441 (44.5)
		Nighttime	388 (39.1)
Sputum			564 (56.9)
Sleep disorder			107 (10.8)
Limitation of activities (including exercise)			70 (7.1)

* Patients with ≥5 days’ worth of entries in their patient diary.

Table 6. Summary of patient-reported outcomes.

		No. of patients (%) or mean ± SD
ACQ-5 score^a		n = 1157
	≤0.75 (controlled asthma)	700 (60.5)
	>0.75, <1.5	276 (23.9)
	≥1.5 (not well-controlled asthma)	181 (15.6)
	Mean score	0.7 ± 0.9
MiniAQLQ score		n = 1152
	Mean score	5.8 ± 1.0
	Symptoms	6.0 ± 1.0
	Limitation on activities	6.1 ± 1.1
	Emotional function	5.8 ± 1.2
	Environmental stimuli	5.0 ± 1.6

^a Categories as described in Jia et al [21].

ACQ: asthma control questionnaire; AQLQ: asthma quality of life questionnaire; SD: standard deviation.

Japan Society of Allergology. Asthma prevention and management guideline. Japan, Tokyo: Kyowakikaku; 2015 (in Japanese).

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