Fixed airflow obstruction in asthma: a descriptive study of patient profiles and effect on treatment responses.
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ABSTRACT:
SUBMITTER: Tashkin DP
PROVIDER: S-EPMC4162502 | biostudies-literature | 2014 Aug
REPOSITORIES: biostudies-literature
Publications
Fixed airflow obstruction in asthma: a descriptive study of patient profiles and effect on treatment responses.
Tashkin Donald P DP Chipps Bradley E BE Trudo Frank F Zangrilli James G JG
The Journal of asthma : official journal of the Association for the Care of Asthma 20140319 6
<h4>Background</h4>The role of fixed airflow obstruction (FAO) in asthma is unclear.<h4>Objective</h4>To assess the relationship between FAO and clinical features of asthma and the effect of FAO on treatment response.<h4>Methods</h4>Post hoc descriptive analysis of data stratified by FAO category (screening post-albuterol FEV1/FVC <lower limit of normal [LLN] [FAO+] or ≥LLN [FAO-]) from two 12-week, randomized, placebo-controlled studies of budesonide/formoterol or the monocomponents in mild-mod ...[more]
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Project description:BACKGROUND:Asthma in older adults is associated with increased morbidity and mortality compared with asthma in younger patients. Fixed airflow obstruction (FAO) is associated with decreased survival in younger patients, but its significance remains unclear in older adults with asthma. OBJECTIVE:To identify risk factors and outcomes related to FAO in older adults with asthma. METHODS:Subjects older than 55 years with a physician diagnosis of persistent asthma were evaluated. Collected data included participant demographic information, medications, asthma exacerbations, Asthma Control Test (ACT) score, Asthma Quality of Life (AQLQ) score, comorbidities, spirometry, atopic status, and fractional exhaled nitric oxide. Clinical characteristics and outcomes associated with FAO (defined as post-bronchodilator ratio of forced expiratory volume in 1 second to forced vital capacity ?70%) were assessed. RESULTS:A total of 186 participants were analyzed (48 men and 138 women, mean age 66 years). FAO was demonstrated in 30% of participants. Using regression analysis, predictors of FAO included advanced age, African American race, male sex, and longer duration of asthma. In outcomes analysis, FAO was associated with worsened ACT and AQLQ scores; however, after controlling for confounding factors, logistic regression showed no association. No significant association was found between FAO and exacerbations, fractional exhaled nitric oxide, atopy, rhinitis, education level, depression, smoking, or body mass index. CONCLUSION:Risk factors associated with FAO in older adults with asthma include advanced age, African American race, increased asthma duration, and male sex. Unlike younger patients, FAO is not independently associated with worsened asthma control, quality of life, or exacerbations in older patients with asthma. TRIAL REGISTRATION:ClinicalTrials.gov identifier: NCT01979055.
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