Asthma and Fixed Airways Obstruction: Real Life Aspects

Area of Science:

• Pulmonology
• Respiratory Medicine
• Clinical Asthma Research

Background:

• Fixed airway obstruction (FAO) is a recognized complication in asthma.
• The impact of FAO on asthma management and patient outcomes requires further investigation.
• Asthma-dedicated clinics aim to improve symptom control and lung function.

Purpose of the Study:

• To evaluate asthmatic patients with FAO and compare their outcomes to asthmatics without FAO.
• To assess the effect of follow-up in an asthma clinic on symptom control and spirometry.
• To identify factors associated with the development of FAO in asthma patients.

Main Methods:

• A cohort study comparing 20 asthmatic patients with FAO (FAO+) and 20 without FAO (FAO-).
• Data collection included medical history, Asthma Control Test (ACT), and spirometry (FEV1) at baseline (T0) and one-year follow-up (T1).
• Statistical analysis compared demographic data, clinical parameters, and changes over time (ΔT0-T1) between groups.

Main Results:

• No significant differences were found between FAO+ and FAO- groups in age, BMI, smoking history, allergies, blood eosinophils, comorbidities, or GINA therapy step.
• A significant delay (>5 years) in asthma diagnosis was observed in the FAO+ group compared to the FAO- group (p < 0.05).
• Both groups showed similar improvements in ACT and FEV1, and comparable numbers of exacerbations at T0 and ΔT0-T1.

Conclusions:

• Fixed airway obstruction in asthma does not necessarily indicate a worse prognosis or reduced treatment response.
• Delayed diagnosis of asthma, leading to potential airway remodeling, is associated with the development of FAO.
• Physicians should accurately diagnose FAO in asthma patients to ensure appropriate management and avoid misdiagnosis with other respiratory conditions.