Ventilation heterogeneity and oscillometry predict asthma control improvement following step-up inhaled therapy in uncontrolled asthma
© 2020 Asian Pacific Society of Respirology..
BACKGROUND AND OBJECTIVE: Abnormal peripheral airway function is an important feature of asthma and relates to asthma symptoms and poor asthma control. We aimed to determine whether peripheral airway function, as measured by forced oscillatory impedance and multiple-breath nitrogen washout (MBNW), relates to symptom improvement in asthmatic participants with uncontrolled asthma, after stepping up to high-dose ICS/LABA treatment.
METHODS: A total of 19 subjects (14 females, mean age: 29.9 ± 13.6 years) with uncontrolled asthma, as defined by an ACQ5 > 1.5, taking 500 μg/day fluticasone equivalent or less, underwent spirometry, plethysmography, fractional exhaled FeNO, forced oscillatory resistance (Rrs5Hz ) and reactance (Xrs5Hz ), and indices of MBNW ventilation heterogeneity (lung clearance index (LCI), diffusion-convection-dependent (Sacin) and convection-dependent (Scond)). Measurements were made before and after 8 weeks of treatment with fluticasone/formoterol combination inhaler 250/10 μg, 2 puffs twice daily.
RESULTS: Treatment improved ACQ5 (P = 0.0002), FEV1 (P = 0.02), FVC (P = 0.04), FeNO (P = 0.0008), Xrs5Hz (P = 0.01), LCI (P = 0.0002), Sacin (P = 0.006) and Scond (P = 0.01). At baseline, ACQ5 correlated with Xrs5Hz (rs = 0.52, P = 0.03) and Rrs5Hz (rs = 0.55, P = 0.02). The improvement in ACQ5 was predicted by more abnormal baseline LCI (P = 0.03), Scond (P = 0.02) and Rrs5Hz (P = 0.006). Baseline Scond was the best predictor of a clinically meaningful improvement in asthma control (ΔACQ > 0.5, ROC-AUC = 0.91, P = 0.007).
CONCLUSION: Step-up to high-dose combination treatment in uncontrolled asthma is associated with improved peripheral airway function as measured by Xrs5Hz and MBNW. Baseline MBNW and FOT parameters correlated with the improvement in symptoms and may predict a positive response to up-titration in uncontrolled asthmatic patients.
Errataetall: |
CommentIn: Respirology. 2020 Aug;25(8):779-780. - PMID 32147896 |
---|---|
Medienart: |
E-Artikel |
Erscheinungsjahr: |
2020 |
---|---|
Erschienen: |
2020 |
Enthalten in: |
Zur Gesamtaufnahme - volume:25 |
---|---|
Enthalten in: |
Respirology (Carlton, Vic.) - 25(2020), 8 vom: 16. Aug., Seite 827-835 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Tang, Francesca S M [VerfasserIn] |
---|
Links: |
---|
Anmerkungen: |
Date Completed 24.06.2021 Date Revised 24.06.2021 published: Print-Electronic CommentIn: Respirology. 2020 Aug;25(8):779-780. - PMID 32147896 Citation Status MEDLINE |
---|
doi: |
10.1111/resp.13772 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM306212994 |
---|
LEADER | 01000naa a22002652 4500 | ||
---|---|---|---|
001 | NLM306212994 | ||
003 | DE-627 | ||
005 | 20231225122852.0 | ||
007 | cr uuu---uuuuu | ||
008 | 231225s2020 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1111/resp.13772 |2 doi | |
028 | 5 | 2 | |a pubmed24n1020.xml |
035 | |a (DE-627)NLM306212994 | ||
035 | |a (NLM)32026586 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Tang, Francesca S M |e verfasserin |4 aut | |
245 | 1 | 0 | |a Ventilation heterogeneity and oscillometry predict asthma control improvement following step-up inhaled therapy in uncontrolled asthma |
264 | 1 | |c 2020 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Completed 24.06.2021 | ||
500 | |a Date Revised 24.06.2021 | ||
500 | |a published: Print-Electronic | ||
500 | |a CommentIn: Respirology. 2020 Aug;25(8):779-780. - PMID 32147896 | ||
500 | |a Citation Status MEDLINE | ||
520 | |a © 2020 Asian Pacific Society of Respirology. | ||
520 | |a BACKGROUND AND OBJECTIVE: Abnormal peripheral airway function is an important feature of asthma and relates to asthma symptoms and poor asthma control. We aimed to determine whether peripheral airway function, as measured by forced oscillatory impedance and multiple-breath nitrogen washout (MBNW), relates to symptom improvement in asthmatic participants with uncontrolled asthma, after stepping up to high-dose ICS/LABA treatment | ||
520 | |a METHODS: A total of 19 subjects (14 females, mean age: 29.9 ± 13.6 years) with uncontrolled asthma, as defined by an ACQ5 > 1.5, taking 500 μg/day fluticasone equivalent or less, underwent spirometry, plethysmography, fractional exhaled FeNO, forced oscillatory resistance (Rrs5Hz ) and reactance (Xrs5Hz ), and indices of MBNW ventilation heterogeneity (lung clearance index (LCI), diffusion-convection-dependent (Sacin) and convection-dependent (Scond)). Measurements were made before and after 8 weeks of treatment with fluticasone/formoterol combination inhaler 250/10 μg, 2 puffs twice daily | ||
520 | |a RESULTS: Treatment improved ACQ5 (P = 0.0002), FEV1 (P = 0.02), FVC (P = 0.04), FeNO (P = 0.0008), Xrs5Hz (P = 0.01), LCI (P = 0.0002), Sacin (P = 0.006) and Scond (P = 0.01). At baseline, ACQ5 correlated with Xrs5Hz (rs = 0.52, P = 0.03) and Rrs5Hz (rs = 0.55, P = 0.02). The improvement in ACQ5 was predicted by more abnormal baseline LCI (P = 0.03), Scond (P = 0.02) and Rrs5Hz (P = 0.006). Baseline Scond was the best predictor of a clinically meaningful improvement in asthma control (ΔACQ > 0.5, ROC-AUC = 0.91, P = 0.007) | ||
520 | |a CONCLUSION: Step-up to high-dose combination treatment in uncontrolled asthma is associated with improved peripheral airway function as measured by Xrs5Hz and MBNW. Baseline MBNW and FOT parameters correlated with the improvement in symptoms and may predict a positive response to up-titration in uncontrolled asthmatic patients | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Research Support, Non-U.S. Gov't | |
650 | 4 | |a asthma control | |
650 | 4 | |a forced oscillation technique | |
650 | 4 | |a multiple-breath nitrogen washout | |
650 | 4 | |a peripheral airway dysfunction | |
650 | 4 | |a ventilation heterogeneity | |
650 | 7 | |a Adrenal Cortex Hormones |2 NLM | |
650 | 7 | |a Adrenergic beta-2 Receptor Agonists |2 NLM | |
650 | 7 | |a Drug Combinations |2 NLM | |
650 | 7 | |a fluticasone-formoterol |2 NLM | |
650 | 7 | |a Fluticasone |2 NLM | |
650 | 7 | |a CUT2W21N7U |2 NLM | |
650 | 7 | |a Nitrogen |2 NLM | |
650 | 7 | |a N762921K75 |2 NLM | |
650 | 7 | |a Formoterol Fumarate |2 NLM | |
650 | 7 | |a W34SHF8J2K |2 NLM | |
700 | 1 | |a Rutting, Sandra |e verfasserin |4 aut | |
700 | 1 | |a Farrow, Catherine E |e verfasserin |4 aut | |
700 | 1 | |a Tonga, Katrina O |e verfasserin |4 aut | |
700 | 1 | |a Watts, Joanna |e verfasserin |4 aut | |
700 | 1 | |a Dame-Carrol, Jessica R |e verfasserin |4 aut | |
700 | 1 | |a Bertolin, Amy |e verfasserin |4 aut | |
700 | 1 | |a King, Gregory G |e verfasserin |4 aut | |
700 | 1 | |a Thamrin, Cindy |e verfasserin |4 aut | |
700 | 1 | |a Chapman, David G |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t Respirology (Carlton, Vic.) |d 1998 |g 25(2020), 8 vom: 16. Aug., Seite 827-835 |w (DE-627)NLM093444214 |x 1440-1843 |7 nnns |
773 | 1 | 8 | |g volume:25 |g year:2020 |g number:8 |g day:16 |g month:08 |g pages:827-835 |
856 | 4 | 0 | |u http://dx.doi.org/10.1111/resp.13772 |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |d 25 |j 2020 |e 8 |b 16 |c 08 |h 827-835 |