Asthma Impairment and Risk Questionnaire predicts short- and long-term exacerbation occurrence across asthma severities

McCann WA, Chipps BE, Beuther DA et al. Ann Allergy Asthma Immunol. 2026 Mar 22:S1081-1206(26)00120-1. doi: 10.1016/j.anai.2026.03.014. 

Abstract

Background

The Asthma Impairment and Risk Questionnaire (AIRQ) predicts 12-month exacerbation occurrence for patients aged ≥12 years.

Objective

To assess the short- and long-term exacerbation prediction ability of the AIRQ in patients with mild-to-moderate and severe asthma.

Methods

This post hoc analysis from the AIRQ longitudinal study classified patients with asthma aged ≥12 years as having mild-to-moderate or severe disease based on prescribed pharmacotherapy. Participant-reported severe asthma exacerbations were assessed monthly over 12 months. For both severity groups and relative to baseline AIRQ control category, exacerbation occurrence was assessed via logistic regression and Kaplan–Meier time-to-first event analyses for the overall 12-month period, months 0-3 (short-term), and months 4-12 (long-term) post-enrollment.

Results

Proportion of patients in the total population (A), with mild-to-moderate
(B) and severe asthma (C) who experienced ≥1 exacerbation over the
short-term (months 0-3) and long-term (months 4-12) follow-up periods
relative to AIRQ control category. AIRQ,
Asthma Impairment and Risk Questionnaire;
NWC, not well-controlled; VPC, very poorly controlled;
WC, well-controlled.

Of 1070 patients who completed ≥1 follow-up assessment, 374 (35.0%) had mild-to-moderate and 696 (65.0%) had severe asthma.

Over the 12-month follow-up, 134 (35.8%) patients with mild-to-moderate disease versus 355 (51.0%) patients with severe disease experienced ≥1 exacerbation (P < .001). Over months 0-3 and months 4-12, the proportion of patients experiencing ≥1 exacerbation was lower in those with mild-to-moderate than severe asthma (76 [21.0%] vs 201 [29.8%], P = .002; 93 [26.1%] vs 283 [41.4%], P < .001, respectively). For both severity groups, over the 12-month follow-up, months 0-3, and months 4-12, baseline AIRQ control category predicted exacerbation occurrence and time to first exacerbation (P < .001 for all).

Conclusion

The AIRQ predicts short- and long-term exacerbation occurrence in patients with mild-to-moderate and severe asthma. Understanding how current asthma control relates to exacerbation risk could facilitate point-of-care shared decision-making on management optimization.

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