Reversible airway obstruction in cystic fibrosis: Common, but not associated with characteristics of asthma

J Cyst Fibros. 2016 Sep;15(5):652-9. doi: 10.1016/j.jcf.2016.01.003. Epub 2016 Jan 28.

Abstract

Background: As asthma-like symptoms are common in CF, we evaluated reversible airway obstruction and associated characteristics.

Methods: Retrospective analysis of charts including spirometry and bronchodilator response.

Results: Of 190 CF patients (103 at Schneider's, 87 at Hadassah), aged 14.4 (4-76) years, median (range), 39% had reversible obstruction (ΔFEV1% predicted ≥12%), associated with younger age (p=0.01) and severe genotype (p=0.02). There was no association with family history of asthma, serum IgE, blood eosinophils, pancreatic status, FEV1<40% predicted, Aspergillus or pseudomonas infection. Of patients with reversible obstruction, 74% were on bronchodilator and 68% on inhaled corticosteroid therapy but 54% and 57% respectively receiving these therapies did not have reversible obstruction.

Conclusions: Reversible airway obstruction is common in CF, more frequent in younger patients and with severe genotype, with no correlation to markers of atopy or CF clinical severity. Bronchodilator and inhaled corticosteroid therapies are commonly prescribed even without reversible obstruction.

Keywords: Airway obstruction; Asthma; Bronchodilator; Cystic fibrosis; Hyperreactivity; Reversibility.

MeSH terms

  • Adolescent
  • Age Factors
  • Aged
  • Airway Obstruction* / diagnosis
  • Airway Obstruction* / etiology
  • Airway Obstruction* / physiopathology
  • Asthma / diagnosis*
  • Biological Availability
  • Bronchial Hyperreactivity / diagnosis
  • Bronchial Hyperreactivity / drug therapy
  • Bronchial Hyperreactivity / etiology
  • Bronchial Hyperreactivity / physiopathology
  • Bronchodilator Agents* / administration & dosage
  • Bronchodilator Agents* / pharmacokinetics
  • Child, Preschool
  • Cystic Fibrosis* / complications
  • Cystic Fibrosis* / diagnosis
  • Cystic Fibrosis* / epidemiology
  • Cystic Fibrosis* / physiopathology
  • Diagnosis, Differential
  • Female
  • Forced Expiratory Volume
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / pharmacokinetics
  • Humans
  • Israel / epidemiology
  • Male
  • Retrospective Studies
  • Spirometry / methods
  • Statistics as Topic

Substances

  • Bronchodilator Agents
  • Glucocorticoids