Abstract
Asthma is classically characterized by full reversal of airway obstruction. However, a significant proportion of patients demonstrate partial obstruction reversibility despite best treatment. We aim to compare characteristics of non-controlled severe asthma patients with persistent (PO) and fixed (FO) airflow obstruction to those with non-persistent obstruction (NPO). Sixty-two non-controlled severe asthmatics received high inhaled corticosteroid dose plus LABA for 12 weeks. In the first two weeks they also received oral prednisone (OC=40mg.day-1). They were evaluated according to ACQ, spirometry, pletismography and Single Breath N2 washout test, at baseline (T-2), after OC trial (T2) and at the end of the study (T12). ACQ and functional data at T-2 and T2 are shown in table below. At T12, all subgroups presented a slight worsening in functional status although still better than baseline.
Our data confirm that a high proportion of severe asthmatic patients persists with airflow obstruction despite optimal theraphy. Small airway measurements are sensitive in identifying those most likely to respond to treatment and may help to understand the pathophysiology involved in remodeling and fixed obstruction in asthmatic patients.
- © 2014 ERS