Impulse oscillometry system useful tool for asthma treatment: Study
Japan: Impulse oscillometry system (IOS) can be used for the examination of bronchial asthma (BA) before the administration of inhaled corticosteroids (ICSs), suggests a recent study in the journal Respiratory Research. This means that IOS could be an effective tool for the selection of ICS and the evaluation of BA phenotype.
Asthma is one of the most common chronic respiratory diseases that affects 1–18% of the population in different countries and is typically characterized by chronic airway inflammation. Asthma is a heterogeneous disease, and the cluster of demographic, clinical, and/or pathophysiological characteristics are often referred to as asthma phenotypes.
Bronchial asthma (BA) has different phenotypes, and it requires a clinically effective subtype classification system. The IOS is an emerging technique device used in respiratory functional tests. However, its efficacy has not been validated. Therefore, this study by Hiroyuki Sugawara, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan, and colleagues aimed to assess the relationship between BA and the IOS parameters, and the difference in the therapeutic effects of ICSs among the subtype classifications was evaluated using the IOS.
The study enrolled 108 patients of the 245 patients with bronchial asthma who were screened. They were divided on the basis of three subtypes according to the IOS result -- central predominant type (n = 34), peripheral predominant type (n = 58), and resistless type (n = 16)
Then, the following ICSs were randomly prescribed in daily medical care: coarse-particle ICS (fluticasone propionate [FP]), fine-particle ICS (mometasone furoate [MF]), and moderate-particle ICS (budesonide [BUD]). Asthma Health Questionnaire (AHQ) and the Asthma Control Test (ACT) were used to assess the treatment effects and were compared among the three subtypes.
Key findings of the study include:
- In the central predominant type, the AHQ score of the MF group was significantly higher than that of the FP group (15.4 vs. 3.6) and the BUD group (15.4 vs. 8.8); the ACT score of the FP group was significantly higher than that of the MF and BUD groups (24.3 vs. 21.7, 22.3) at 4 weeks after treatment.
- In the peripheral predominant type, the AHQ score of the FP group was significantly higher than that of the MF group (14.1 vs. 3.4); the ACT score of the FP group was lower than that of the MF and BUD groups (22.8 vs. 24.6) at 4 weeks after treatment.
"An association was observed between IOS subtype classification and ICS particle size in terms of therapeutic efficacy in BA. This result indicates that the IOS could be an effective tool in the selection of ICS and the evaluation of the BA phenotype," concluded the authors.
The study, "A retrospective analysis of usefulness of impulse oscillometry system in the treatment of asthma," is published in the journal Respiratory Research.
DOI: https://doi.org/10.1186/s12931-020-01494-x
