Asthma control in patients on fixed dose combination evaluated with mannitol challenge test

Summary Asthma is often difficult to control and it is likely that not all patients are optimally treated. This study aimed to explore asthma control in adults receiving fixed dose combination (FDC) therapy. Control of asthma was assessed using the mannitol challenge test as a monitoring tool to see...

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Bibliographic Details
Published in:	Respiratory medicine Vol. 108; no. 2; pp. 264 - 270
Main Authors:	Romberg, Kerstin A.M, Berggren, Anna-Carin, Bjermer, Leif
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01-02-2014 Elsevier Limited
Subjects:	ACT Administration, Inhalation Adolescent Adult Aged Anti-Asthmatic Agents - administration & dosage Asthma Asthma - physiopathology Asthma - prevention & control Beta2-agonist Blood pressure Bronchial Provocation Tests - methods Bronchoconstrictor Agents Clinical Medicine Confidence intervals Dermatitis Drug Combinations Family medical history Female Forced Expiratory Volume - drug effects Humans Hyperresponsiveness Inflammation Klinisk medicin Lungmedicin och allergi Male Mannitol Medical and Health Sciences Medicin och hälsovetenskap Middle Aged Prospective Studies Pulmonary/Respiratory Respiratory Medicine and Allergy Spirometry Vital Capacity - drug effects Young Adult Sweden Hyperresponsiveness Spirometry ACT Inflammation Beta2-agonist
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Summary:	Summary Asthma is often difficult to control and it is likely that not all patients are optimally treated. This study aimed to explore asthma control in adults receiving fixed dose combination (FDC) therapy. Control of asthma was assessed using the mannitol challenge test as a monitoring tool to see if this would give additional information compared to the asthma control test (ACT). The study was an open-label, prospective study on 98 adults prescribed with FDC therapies for at least three months. 74 patients considered that their asthma was well controlled. However, 60 patients had a positive mannitol challenge test (PD15 < 635 mg), and when those with a positive response to the short-acting β2 -agonist (≥15%) after the mannitol challenge test were included, this increased to 64 patients (65%). Exploratory analysis determined that the spirometry parameters; FEV1 /FVC and FEV1 % of predicted, were statistically significant predictors of a positive mannitol challenge test. Co-morbid conditions such as concomitant upper airway involvement or eczema did not predict mannitol reactivity. Although most patients rated their asthma as well controlled, many provided a positive mannitol challenge test, suggesting the presence of underlying inflammation, despite treatment with fixed dose combination therapy.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23
ISSN:	0954-6111 1532-3064 1532-3064
DOI:	10.1016/j.rmed.2013.12.005