Symptom burden to characterise, predict, and prevent asthma attacks: a patient-level meta-analysis of randomised trials and translational prospective studies.
Lancet Respir MedAug 20, 2026 (epub)
Simon Couillard, Fleur L Meulmeester, Pascal Charland et al.
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In 30 seconds
This patient-level meta-analysis evaluated the prognostic value of symptom burden, measured by the ACQ-5, in predicting severe asthma attacks among 7161 participants from various studies. The analysis found that each 0.5-point increase in ACQ-5 score was associated with a modest increase in future asthma attack risk (adjusted rate ratio 1.09).
Key findings
- 39% to 100% of patients had a high symptom burden (ACQ-5 score >1.5).
- Each 0.5-point increase in ACQ-5 score was linked to a 9% increase in future asthma attack risk.
- High blood eosinophil counts and FeNO were associated with greater treatment response.
- ACQ-5 scores did not correlate with post-corticosteroid lung function changes.
Why it matters
Understanding the relationship between symptom burden and asthma attacks can help clinicians better assess risk and tailor treatment strategies. This study highlights the limited predictive value of symptoms compared to biological markers.