title: Treatment response according to small airway phenotypes: a real-life observational study.
abstract: Scant clinical data are available on the effects of current treatments for asthma on different subgroups of patients with this disease. We conducted a prospective, noninterventional, multicenter real-life study in adult patients with persistent asthma, and we specifically analyzed the effects of treatment with extrafine beclometasone dipropionate/formoterol (BDP/F) in asthma patients categorized by phenotypes related to small airways (i.e. smoking habits, disease duration, and air trapping).
  
  
  
  Patients received BDP/F as a fixed combination (100/6 μg), administered in 1-2 inhalations twice daily over a period of 12 weeks. Peak expiratory flow (PEF), forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), number of asthma attacks, asthma control, and severity of asthma symptoms were evaluated in the overall population and in different subgroups at three different time points.
  
  
  
  Overall, 213 patients were enrolled. In the overall population the treatment resulted in a significant increase in the proportion of well controlled patients (from 6.1% to 66.3%; p<0.001), and a reduction of uncontrolled subjects (70.3% versus 10.0%; p<0.001). BDP/F was also associated with a reduction in asthma attacks and an improvement of symptoms. These results were confirmed in specific subgroups of patients identified as small airway phenotypes: smokers, elderly patients, those with long duration of disease and air trapping.
  
  
  
  This real-life observational study indicates that extrafine BDP/F in a fixed combination improves asthma control and symptoms in the overall population as well as specific subgroups of patients.
authors.affiliation: Krankenhaus Hietzing, Vienna, Austria.
authors.forename: Katharina
authors.initials: K
authors.lastname: Marth
authors.affiliation: Chiesi Farmaceutici S.p.A, Parma, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Spinola
authors.affiliation: Chiesi Pharmaceuticals GmbH, Vienna, Austria.
authors.forename: Judith
authors.initials: J
authors.lastname: Kisiel
authors.affiliation: Chiesi Pharmaceuticals GmbH, Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Woergetter
authors.affiliation: Krankenhaus Hietzing, Vienna, Austria.
authors.forename: Milos
authors.initials: M
authors.lastname: Petrovic
authors.affiliation: 1130 Wien, KH Hietzing, Abt. f. Atmungs- u. Lungenkrankheiten, Austria wolfgang.pohl@wienkav.at.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Pohl
mesh_terms: D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001507:Beclomethasone / Q000008:administration & dosage* / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D005541:Forced Expiratory Volume; D000068759:Formoterol Fumarate / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010366:Peak Expiratory Flow Rate; D010641:Phenotype; D011446:Prospective Studies; D012907:Smoking; D013997:Time Factors; D016896:Treatment Outcome; D014797:Vital Capacity
chemical_list: D018927:Anti-Asthmatic Agents; D004338:Drug Combinations; D001507:Beclomethasone; D000068759:Formoterol Fumarate
keywords: asthma; beclometasone; extrafine particles; formoterol; phenotypes; small airways