Evaluating the FEV1/FVC ratio in the lower range of normality as a marker of worse clinical outcomes in asthmatic subjects without airway obstruction

Respir Med. 2020 Feb:162:105880. doi: 10.1016/j.rmed.2020.105880. Epub 2020 Jan 20.

Abstract

Background: We should continually improve tools for evaluating asthma. The aim of this study was to evaluate whether the FEV1/FVC ratio in the lower range of normality is associated with worse outcomes in asthmatics without airway obstruction.

Methods: We screened asthmatics at eight clinics. Subjects answered the Asthma Control Questionnaire and underwent spirometry. We assigned individuals without airway obstruction in three groups according to the post bronchodilator FEV1/FVC ratio: lower range of normality, intermediary range of normality and upper range of normality. Asthma outcomes were hospital admission due to asthma during the preceding year, non-controlled asthma symptoms and moderate-high inhaled maintenance therapy need.

Results: In subjects from six to 18 years old, the rate of hospital admission was higher in the group with FEV1/FVC ratio in the lower range of normality as compared with the other two groups but the frequency of non-controlled symptoms of asthma and moderate-high dose of inhaled maintenance therapy need was similar. From 19 to 59 years old, the rate of moderate-high inhaled maintenance therapy need was higher in the group with FEV1/FVC ratio in the lower range of normality as compared with the other two groups, but the frequency of hospital admissions and non-controlled symptoms of asthma was similar. Above 59 years old, there was no difference in clinical asthma outcomes between lung function groups.

Conclusions: FEV1/FVC ratio in the lower range of normality is a marker of worse clinical outcomes in asthmatics without airway obstruction.

Keywords: Asthma; Corticosteroids; Epidemiology; Exacerbation; Treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Airway Obstruction
  • Anti-Asthmatic Agents / administration & dosage
  • Asthma / diagnosis*
  • Asthma / drug therapy
  • Asthma / physiopathology*
  • Biomarkers
  • Child
  • Female
  • Forced Expiratory Flow Rates*
  • Forced Expiratory Volume*
  • Hospitalization / statistics & numerical data
  • Humans
  • Maintenance Chemotherapy
  • Male
  • Prognosis
  • Spirometry
  • Surveys and Questionnaires

Substances

  • Anti-Asthmatic Agents
  • Biomarkers