[Relevance of the ACT score in severe asthma with obesity: A pilot study]

The Asthma Control Test (ACT) is an easy-to-use tool assessing the level of asthma control. However, interpretation in a population of severe asthma patients with obesity may be partially biased due to symptoms directly associated with obesity.

The RAMSES study is a nationwide cohort of severe asthma patients. In this pilot study, we considered a subgroup of patients recruited in our center, compared the ACT scores of obese and non-obese severe asthma patients, and analysed associations between ACT scores and phenotypic features.

Forty non-obese and 25 obese severe asthmatics were included in the study. The ACT score did not differ between the two groups, nor was it correlated with body mass index. Unlike the non-obese group, the ACT score in the obese group was not associated with number of exacerbations (P=0.158), number of hospitalizations (P=0.840), or the HADS anxiety (P=0.105) and depression (P=0.056) scores.

Our results suggest that the ACT score may not fully reflect asthma control in the obese severe asthma population. They rather tend to indicate a distinct severe asthma and obesity phenotype, in which a low ACT score would not be associated with number of exacerbations or psychological burden, thereby highlighting the primordiality of comprehensive assessment and multidisciplinary management.