Page 78 - Comprehensive treatment of patients with glucocorticoid-dependent severe asthma

Chapter 4
symptoms, activity limitations, emotional functioning, and environmental stimuli [20]. The mean of the 32 items in the AQLQ between 1 (very poor asthma related quality of life) and 7 (best asthma related quality of life) was used.
The 20-question Sino-Nasal Outcome test (SNOT-20) was used to measure rhinosinusitis-related quality-of-life. The mean total score ranges from 0 (no symptoms) to 5 (severe symptoms) and is calculated by averaging an individual’s responses to all questions [21].
The severity of fatigue was measured by the subscale Subjective Fatigue from the multidimensional Checklist Individual Strength (CIS) [22]. The Subjective Fatigue subscale of the CIS (CIS-Fatigue) consists of 8 items, scored on a seven point Likert-scale, higher scores meaning worse outcomes.
Lung function assessment
Pulmonary function testing was performed using the Masterscreen PTF (Jaeger Viasys, Germany). Forced expiratory volume in one second (FEV1) was assessed before and after inhaled administration of 400 μg salbutamol and expressed as percentage of predicted value [23].
Exercise tolerance
The Six-Minute Walk Test (6MWT) measures the maximum distance an individual is able to walk on a flat, hard surface in a period of 6 minutes (6MWD) [24]. The self-paced 6MWT assess the submaximal level of functional capacity of the patient and reflects the functional exercise level for daily physical activities. An improvement of 54 meters has been shown to be a clinically important difference [25].
Assessment of allergy and inflammation
Total IgE and specific IgE to common aero-allergens (house dust mites, mixed grass and birch pollen, cat and dog dander and Aspergillus fumigatus) in peripheral blood was assessed by fluroenzyme immunoassay UniCAP® (Pharmacia & Upjohn, Uppsala, Sweden) and expressed in kU.L-1.
Eosinophils in peripheral blood were measured by standard automated cell counter.
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