Abstract
Minimal clinically important difference (MCID) can be defined as the smallest change or difference in an outcome measure that is perceived as beneficial and would lead to a change in the patient's medical management.
The aim of the current expert consensus report is to provide a “state-of-the-art” review of the currently available literature evidence about MCID for end-points to monitor asthma control, in order to facilitate optimal disease management and identify unmet needs in the field to guide future research.
A series of MCID cut-offs are currently available in literature and validated among populations of asthmatic patients, with most of the evidence focusing on outcomes as patient reported outcomes, lung function and exercise tolerance. On the contrary, only scant and partial data are available for inflammatory biomarkers. These clearly represent the most interesting target for future development in diagnosis and clinical management of asthma, particularly in view of the several biologic drugs in the pipeline, for which regulatory agencies will soon require personalised proof of efficacy and treatment response predictors.
Abstract
Minimal clinically important difference (MCID) cut-offs in asthma are validated for patient reported outcomes and lung function, but not for inflammatory biomarkers. MCID represents a key target for future development in asthma management. http://bit.ly/33hcWIe
Footnotes
Provenance: Submitted article, peer reviewed
Author contributions: All authors actively participated in determining the contents included in the review, drafting the manuscript and revising it critically. All authors approved the final version of the article for submission.
Conflict of interest: M. Bonini has nothing to disclose.
Conflict of interest: M. Di Paolo has nothing to disclose.
Conflict of interest: D. Bagnasco has nothing to disclose.
Conflict of interest: I. Baiardini has nothing to disclose.
Conflict of interest: F. Braido has nothing to disclose.
Conflict of interest: M. Caminati has nothing to disclose.
Conflict of interest: E. Carpagnano has nothing to disclose.
Conflict of interest: M. Contoli reports grants from Chiesi, personal fees from Chiesi, AstraZeneca, Boehringer Ingelheim, Novartis Menarini, Mundipharma, Almirall and Zambon, and grants from University of Ferrara (Italy), outside the submitted work.
Conflict of interest: A. Corsico has nothing to disclose.
Conflict of interest: S. Del Giacco has nothing to disclose.
Conflict of interest: E. Heffler has nothing to disclose.
Conflict of interest: C. Lombardi has nothing to disclose.
Conflict of interest: I. Menichini has nothing to disclose.
Conflict of interest: M. Milanese has nothing to disclose.
Conflict of interest: N. Scichilone has nothing to disclose.
Conflict of interest: G. Senna has nothing to disclose.
Conflict of interest: G.W. Canonica has nothing to disclose.
Support statement: The current work has been supported by a RESPIRE2 ERS/Marie-Curie Fellowship awarded to M. Bonini and has been developed as a joint initiative on behalf of the Asthma Section of the Italian Society of Allergy, Asthma and Clinical Immunology (SIAAIC) and the Italian Respiratory Society (IRS).
- Received October 25, 2019.
- Accepted March 9, 2020.
- Copyright ©ERS 2020.
This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.