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VAS asthma is linked to small airway resistance in symptomatic patients using as-needed inhaled corticosteroids-formoterol.
A single-center, prospective cohort study revealed the presence of increased small airway resistance in symptomatic patients who used as-needed inhaled corticosteroids-formoterol to manage visual analogue scale (VAS) asthma. The investigators sought to establish a connection between symptoms (evaluated using VAS) and metrics of small airways resistance in asthma subjects. Their goal was to ascertain if people with milder symptoms exhibited higher levels of small airway resistance.
Individuals with controlled asthma who used as-needed inhaled corticosteroids-formoterol (n=29) were enrolled in the study. The evaluation included their symptom VASs, Spirometry, and impulse oscillometry (IOS), which assessed small airway resistance (measured as R5-R20%). These assessments were conducted during both symptomatic and less symptomatic periods. To gauge their symptoms, MASK-air, a mobile health application (mHealth app) with a validated VAS-based daily monitoring questionnaire, was employed. The correlation between the VAS scores in MASK-air and small airway resistance was carried out.
During symptomatic periods, a notable association was observed between VAS asthma and R5-R20% (r = 0.43). However, such a correlation was not evident during less symptomatic periods (r = 0.04). In less symptomatic periods, subjects with VAS asthma scores below 30 exhibited a median R5-R20% of 0.26, which was lower than the remainder of 0.35 in other patients. Additionally, their R5% was lower at 0.13, compared to 0.15 in the remaining patients. Notably, 68.9% of patients experiencing milder symptoms had R5-R20 values that remained elevated beyond the normal range.
Symptomatic patients who rely on as-needed inhaled corticosteroids-formoterol tend to experience heightened small airway resistance associated with their VAS asthma. Interestingly, even when these patients exhibit fewer symptoms, their small airway resistance may still surpass the normal range. Given the significant impact of small airway dysfunction on asthma management, it is crucial to maintain diligent patient monitoring, even during periods of reduced symptomatology.
Journal of Asthma
In symptomatic patients on as-needed inhaled corticosteroids-formoterol, VAS asthma is associated with small airways resistance
Ilgim Vardaloglu et al.
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