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. 2025 Feb;134(2):209-214.e2.
doi: 10.1016/j.anai.2024.10.012. Epub 2024 Oct 16.

The Supraglottic Index: An indicator of response to laryngopharyngeal reflux therapy in asthma

Laurie A Manka  1 , Vamsi P Guntur  2 , Allen D Stevens  2 , Christena Kolakowski  2 , Camille M Moore  3 , Richard J Martin  2
Affiliations

The Supraglottic Index: An indicator of response to laryngopharyngeal reflux therapy in asthma

Laurie A Manka et al. Ann Allergy Asthma Immunol. 2025 Feb.

Abstract

Background: Laryngopharyngeal reflux (LPR) is associated with gastroesophageal reflux and is known to cause poor asthma control. Moreover, LPR and asthma frequently coexist in the same individual. Controlling LPR could be associated with improved asthma control. The Supraglottic Index (SGI) is a clinically applied visual scale, which correlates with the presence of LPR. The role of SGI in monitoring LPR therapy in individuals with asthma is not known.

Objective: To determine whether the SGI can be used over time to assess the presence of LPR in patients with asthma, and whether the SGI improves with LPR treatment.

Methods: This is a pilot study in 15 participants with asthma. Those without evidence of LPR by SGI measurement were assigned to the observation arm. Those with LPR were assigned to the treatment arm and were treated with either standard-of-care LPR treatment (antacids and behavioral management) or a novel therapy (upper esophageal assist device).

Results: The SGI remained stable in individuals with asthma who underwent observation over 8 weeks. The SGI improved in participants with asthma treated for LPR (P = .024).

Conclusion: The SGI is a readily available clinical tool to assess the presence of LPR and monitor its therapy in asthma.

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Conflict of interest statement

Disclosures Dr Manka has received consultant fees from GlaxoSmithKline and CarelonRx, unrelated to this report. Dr Guntur has received consultant fees from AstraZeneca and Regeneron, unrelated to this report. The remaining authors have no conflicts of interest to report.