Purpose Few questionnaires evaluate daytime and nighttime symptoms separately, although these assessments could contribute to the improvement of disease control levels and prevention of future risks in asthma. The purpose of this retrospective study was to investigate whether daytime and nighttime visual analog scales (VAS) are useful in measuring the perception of symptoms, assessing disease control levels, and evaluating the treatment effects in asthma. Patients and Methods Self-reporting asthma control tests (ACT) before and after treatment are standardized tests used to determine disease control levels. A multiple regression analysis was performed to determine the correlation between daytime and nighttime VAS and the characteristics of patients before treatment, as well as the changes in VAS and lung functions and fractional exhaled nitrogen oxide after treatment in 55 treatment-naïve symptomatic adult patients with asthma. Results Both daytime ( r = −0.57, P < 0.0001) and nighttime ( r = −0.46, P < 0.0001) VAS correlated well with ACT scores, and there was a correlation between daytime and nighttime VAS ( r = 0.33, P = 0.0148) before treatment. In addition, the changes in daytime ( r = −0.65, P < 0.0001) and nighttime ( r = −0.44, P < 0.0001) VAS were significantly associated with changes in the ACT scores. The multiple regression analysis ( β [95% confidence interval]) revealed that improvements in the daytime (−2.33 [−4.55 to −0.11], P = 0.0405) and nighttime (−3.09 [−6.25 to 0.07], P = 0.0505) VAS were associated with an increased forced vital capacity after treatment, although there was no correlation between the VAS and characteristics before treatment. Conclusion Our study demonstrated that daytime and nighttime VAS were useful in assessing disease control levels and evaluating the treatment effects in asthma.
Purpose The efficacy and safety of first-line triple and dual therapy remain unclear because the stepwise strategy is a worldwide standard in controller-naïve asthma. A preliminary retrospective cohort study was conducted to investigate the efficacy and safety of first-line triple and dual therapy for managing controller-naïve and symptomatic adult patients with asthma. Patients and Methods Patients with asthma who received first-line single-inhaler triple therapy (SITT) or dual therapy (SIDT) for at least 8 weeks were selected between December 1, 2020, and May 31, 2021, in Fujiki Medical and Surgical Clinic, Miyazaki, Japan. Data on daytime and nighttime visual analog scale (VAS) scores, lung function tests, fractional exhaled nitrogen oxide (F E NO), and adverse events were compared between SITT and SIDT pre- and post-treatment. Results The SITT significantly improved the nighttime, but not daytime, VAS scores better than the SIDT 2 weeks post-treatment ( P = 0.0026), whereas SITT and SIDT significantly improved daytime and nighttime VAS scores after treatment compared to baseline. Both therapies also significantly improved lung functions and F E NO post-treatment. The proportion of patients achieving complete control in the nighttime VAS scores after SITT was significantly higher than that four ( P = 0.0186) and 8 weeks ( P = 0.0061) after SIDT. Only patients with SITT experienced dry mouth. Conclusion Our study demonstrated that first-line SITT and SIDT were effective, and SITT improved disease control faster than SIDT in controller-naïve and symptomatic adult patients with asthma. The first-line SITT may contribute to faster and better control levels in symptomatic patients with asthma.
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