title: Asthma control in patients on fixed dose combination evaluated with mannitol challenge test.
abstract: 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.
authors.affiliation: Näsets Läkargrupp Falsterbovägen, Hӧllviken, Sweden; Skane University Hospital, Department of Respiratory Medicine and Allergology, Lund, Sweden. Electronic address: kro@nlg.nu.
authors.forename: Kerstin A M
authors.initials: KA
authors.lastname: Romberg
authors.affiliation: Mundipharma AB, Mölndalsvägen, Gӧteborg, Sweden.
authors.forename: Anna-Carin
authors.initials: AC
authors.lastname: Berggren
authors.affiliation: Skane University Hospital, Department of Respiratory Medicine and Allergology, Lund, Sweden.
authors.forename: Leif
authors.initials: L
authors.lastname: Bjermer
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000503:physiopathology / Q000517:prevention & control*; D001985:Bronchial Provocation Tests / Q000379:methods; D016085:Bronchoconstrictor Agents; D004338:Drug Combinations; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D008297:Male; D008353:Mannitol; D008875:Middle Aged; D011446:Prospective Studies; D014797:Vital Capacity / Q000187:drug effects; D055815:Young Adult
chemical_list: D018927:Anti-Asthmatic Agents; D016085:Bronchoconstrictor Agents; D004338:Drug Combinations; D008353:Mannitol
keywords: ACT; Beta2-agonist; Hyperresponsiveness; Inflammation; Spirometry