Please use this identifier to cite or link to this item: https://doi.org/10.1186/1471-2466-14-191
Title: Fixed airways obstruction among patients with severe asthma: Findings from the Singapore General Hospital-Severe Asthma Phenotype Study
Authors: Yii, A.C.A
Tan, G.L
Tan, K.L 
Lapperre, T.S 
Koh, M.S 
Keywords: acetylsalicylic acid
allergen
beta 2 adrenergic receptor stimulating agent
corticosteroid
bronchodilating agent
adult
airway obstruction
allergen sensitization
allergic rhinitis
allergy test
anxiety
Article
asthma
cohort analysis
comorbidity
controlled study
demography
depression
drug megadose
drug sensitivity
eczema
female
fixed airways obstruction
forced expiratory volume
forced vital capacity
gastroesophageal reflux
health care utilization
human
lung function test
major clinical study
male
prick test
sensitization
Singapore
sleep disordered breathing
smoking
vocal cord disorder
aged
airway obstruction
asthma
cross-sectional study
Dermatitis, Atopic
drug effects
drug resistance
middle aged
pathophysiology
phenotype
retrospective study
risk factor
severity of illness index
vital capacity
Adult
Aged
Airway Obstruction
Asthma
Bronchodilator Agents
Cross-Sectional Studies
Dermatitis, Atopic
Drug Resistance
Female
Forced Expiratory Volume
Humans
Male
Middle Aged
Phenotype
Retrospective Studies
Risk Factors
Severity of Illness Index
Singapore
Smoking
Vital Capacity
Issue Date: 2014
Citation: Yii, A.C.A, Tan, G.L, Tan, K.L, Lapperre, T.S, Koh, M.S (2014). Fixed airways obstruction among patients with severe asthma: Findings from the Singapore General Hospital-Severe Asthma Phenotype Study. BMC Pulmonary Medicine 14 (1) : 191. ScholarBank@NUS Repository. https://doi.org/10.1186/1471-2466-14-191
Rights: Attribution 4.0 International
Abstract: Background: A subset of severe asthma patients has fixed airways obstruction, which is characterized by incomplete reversibility to bronchodilator challenge. We aimed to elucidate the factors associated with fixed airways obstruction in a cohort of patients with severe asthma in Singapore. Methods: 245 patients from the Singapore General Hospital-Severe Asthma Phenotype Study (SGH-SAPS) were screened. These patients fulfilled World Health Organization criteria for "treatment-resistant severe asthma" and were all on combination of high-dose inhaled corticosteroids and long-acting beta2 agonists. 76 patients had pre- and postbronchodilator lung function tests and were selected for analysis. They were divided into two groups based on postbronchodilator (Post BD) forced expiratory volume in one second, PostBDFEV1 % predicted: ≥70% (Non-Fixed Obs) and < 70% (Fixed Obs). We compared clinical and demographic parameters between the two groups. Results: Patients in the Fixed Obs group were more frequently past or current smokers and had a higher pack-year smoking history. Overall, pack-year smoking history had a modest negative correlation with PostBDFEV1 % predicted. Atopy, allergen sensitization (type and numbers), comorbidities, symptoms, health care utilization and medication use did not differ between the two groups. The prebronchodilator FEV1 % predicted, FEV1/FVC and FVC % predicted were significantly lower in the Fixed Obs group. In addition, prebronchodilator FVC % predicted accounted for more variability than FEV1/FVC in predicting PostBDFEV1% predicted. Conclusion: Smoking is associated with fixed airways obstruction in patients with treatment-resistant severe asthma in Singapore. Furthermore, our results suggest that both small and large airways obstruction contribute independently to fixed airways obstruction in severe asthma. © 2014 Yii et al.
Source Title: BMC Pulmonary Medicine
URI: https://scholarbank.nus.edu.sg/handle/10635/181477
ISSN: 14712466
DOI: 10.1186/1471-2466-14-191
Rights: Attribution 4.0 International
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