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Barcelona 2013
Tuesday, 10.09.2013
Diagnosis and management of respiratory diseases
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Does measuring pre or post bronchodilator FEV1 influence the level of asthma control in patients with controlled or partially controlled asthma as measured by GINA scale?
M. Vieira, M. Pizzichini, C. Rocha, E. Pizzichini (Florianopolis, Brazil)
Source:
Annual Congress 2013 –Diagnosis and management of respiratory diseases
Session:
Diagnosis and management of respiratory diseases
Session type:
Thematic Poster Session
Number:
4162
Disease area:
Airway diseases
Abstract
Background: GINA guidelines indicate that patients with controlled asthma (CA) must have a FEV1 ≥ 80% and the “FEV1 to be used is without bronchodilator (BD) on treatment”. Because of this cut point, minor changes in FEV1 may alter asthma control (AC) from CA to partially controlled asthma (PCA) and vice versa.
Objective: To determine if establishing AC according to GINA using pre or post BD FEV1 withholding or not IC+LABA alters AC level in patients with CA or PCA.
Methods: We enrolled 51 asthmatics [CA (n=22), PCA (n=29)]. All were stable on treatment for at least three months. Spirometry was performed withholding or not IC+LABA for 12 hours.
Results: The mean (SD) pre BD FEV1 on IC+LABA differed from post BD FEV1 expressed in liters [2.9 (0.9)L vs. 3.0 (0.9)L, p <0.001] or in % from predicted [84.5 (14.7)% vs. 86.9 (14.3)%, p<0.001]. When off IC+LABA the pre BD FEV1 also differ from the post BD FEV1 expressed in liters [2.7 (0.9)L vs. 2.9 (1.0)L] or % predicted [80.2 (15.7)% vs. 84.5 (15.3)]. Using pre or post BD FEV1 on IC+LABA did not influence AC level. However, measuring the pre-BD FEV1 withholding IC+LABA changed AC level in 5(22%) subjects with CA and in 4(13.8%) with PCA while the post BD FEV1 changed AC only in 3 (13.6%) patients with CA.
Conclusion: Both pre or post BD FEV1 on IC+LABA treatment can be used to establish AC. Despite the small changes, the pre BD FEV1 whitholding IC+LABA altered AC in one of each five patients with CA. These results provide an opportunity to investigate benefits of withholding IC+LABA to establish control in these patients.
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Citations should be made in the following way:
M. Vieira, M. Pizzichini, C. Rocha, E. Pizzichini (Florianopolis, Brazil). Does measuring pre or post bronchodilator FEV1 influence the level of asthma control in patients with controlled or partially controlled asthma as measured by GINA scale?. Eur Respir J 2013; 42: Suppl. 57, 4162
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