The challenge:
People living with severe asthma face a heavy burden from symptoms, treatments and side effects. Yet existing health-related quality-of-life measures were designed for asthma in general and missed much of what matters most to this group. As new biologic therapies arrived, clinicians, regulators and industry needed a way to capture the impact of treatment from the patient’s point of view.
What we did:
Researchers in the South West developed the SAQ, the first health-related quality-of-life questionnaire designed specifically for severe asthma. It was built with patients from the start, and their own accounts of living with the condition shaped its content. Novartis and GlaxoSmithKline supported its original development (1-3).
Later, AstraZeneca supported further work, delivered with NIHR ARC South West (operating as PenARC at the time of the research). This work showed that changes in SAQ scores within the first few months of starting a biologic can signal which patients are responding to treatment, well before the usual 12-month review (4).
The impact:
- Recommended as the adult quality-of-life measure in the Core Outcome Measures set for Severe Asthma (COMSA), developed by the international 3TR collaboration (5, 6)
- Available in 17 validated languages
- Used routinely in national severe asthma registries, including those in the Netherlands, Denmark, South Korea and Thailand
Why it matters for partners:
The SAQ shows what our collaborations can deliver: rigorous, patient-led research that produces tools industry can use, with real benefit for patients and the NHS.
Income generation:
The SAQ is licensed for use in commercial studies, generating income for the University of Plymouth, and University Hospitals NHS Trust, supporting further research.
References
- Hyland ME, Jones RC, Lanario JW, Masoli M. The construction and validation of the Severe Asthma Questionnaire. Eur Respir J. 2018;52(1).
- Lanario JW, Hyland ME, Menzies-Gow A, Mansur AH, Dodd JW, Fowler SJ, et al. Validation of subscales of the Severe Asthma Questionnaire (SAQ) using exploratory factor analysis (EFA). Health and quality of life outcomes. 2020;18(1):1-10.
- Masoli M, Lanario J, Hyland M, Menzies-Gow A, Mansur A, Allen D, et al. The Severe Asthma Questionnaire (SAQ)-minimal clinically important difference and sensitivity to change. European Respiratory Society; 2021.
- Davies D, Lanario JW, Hyland ME, Masoli M. Severe Asthma Questionnaire (SAQ) and Asthma Control Questionnaire (ACQ) as Early Predictors of Biologic Response in Severe Asthma. Journal of Asthma and Allergy. 2025:743-52.
- Khaleva E, Rattu A, Brightling C, Bush A, Bossios A, Bourdin A, et al. Development of Core Outcome Measures sets for paediatric and adult Severe Asthma (COMSA). Eur Respir J. 2023;61(4).
- Khaleva E, Brightling C, Eiwegger T, Altraja A, Bégin P, Blumchen K, et al. Patient-centred composite scores as tools for assessment of response to biological therapy for paediatric and adult severe asthma. European Respiratory Journal. 2025;65(3).
Dr Joseph Lanario, University of Plymouth“Working with industry has been a genuine partnership. It has given us insight into what matters to companies developing new treatments and helped us make sure the patient’s voice is part of how those treatments are judged.”