Assessment of asthma control: clinical, functional and inflammatory aspects
Abstract
Background: Asthma is a complex disease with numerous markers of severity/activity.Clinical assessment, functional parameters and inflammation biomarkers are the mostused. A correlation between them is difficult, as each one evaluates a particular aspectof the disease. Objective and Methods: To explore the possible association betweenasthma control, pulmonary function and inflammation in patients with asthma, consecutiveasthmatics underwent simultaneous spirometry (measurement of FEV1), exhalednitric oxide (eNO) evaluation and Asthma Control Test (ACTTM) questionnaire.Results: The study included 232 asthmatics (mean age: 37.48 years; 78.4% female):43% had uncontrolled asthma (ACTTM≤19) with FEV1 mean values of83.3%±21.8; 48% partially controlled (ACTTM:20-24) with FEV1 of 87.6%±17;9% complete control (ACTTM=25) with FEV1 of 93.1±20.6. The relationACTTM/FEV1 and ACTTM/FEF25-75% was statistically significant (p=0.001and p=0.034, respectively). Among patients with eNO -35 ppb, 66% had FEV1 + 80%and 52% had ACTTM + 19. No association was found combining ACTTM/eNO orFEV1/eNO. A subgroup of 66 patients was evaluated twice. Conclusion: An associationwas found between ACTTM and spirometry, with higher ACTTM scores reflectingless bronchial obstruction. The authors advise a combined approach in asthmafollow-up, involving clinical aspects, functional parameters and inflammation biomarkers,although in some circumstances ACT could be a valid instrument to be usedalone to assess control.
Keywords
Asthma control; exhaled nitric oxide;FEV1; spirometry
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