Response of Patients with Chest Tightness Variant Asthma with routine asthma management regimen: A one-year Multicenter, Prospective Real-life Study

Background: Although asthmatic patients with chest tightness as their only presenting symptom (chest tightness variant asthma, CTVA) have clinical characteristics of eosinophilic airway inflammation similar to those of classic asthma (CA), the response of CTVA to treatment regimens used for CA is unclear. Objective: The response of 76 CTVA patients to standard asthma treatments with inhaled corticosteroids with long-acting beta-agonists was explored. Methods: The study was a multicenter, prospective, real-life study conducted in 16 centers in China. The primary efficacy endpoint was the changes in 5-point asthma control questionnaire (ACQ-5) score before and after treatment. Results: After 52 weeks of treatment with therapy regimens used for CA, the ACQ-5 scores decreased markedly from 1.38±0.91 (first administration) to 0.74±0.75 (26 weeks), and 0.71±0.78 (52 weeks) (P<0.01), and the mean decrease for ACQ-5 between 52 weeks and first administration was 0.674(95%CI 0.447-0.9, P<0.001), while the asthma quality of life questionnaire (AQLQ) scores increased from 5.77±0.75 (first administration) to 6.23±0.59 (26 weeks) and 6.20±0.58 (52 weeks) (P<0.01), and the mean increase for AQLQ between 52 weeks and first administration was 0.441(95%CI 0.258-0.625, P<0.001). Diurnal variation in peak expiratory flow (PEF) decreased from 18.4%±9.78(first administration) to 9.32%±5.33 (52 weeks) (P<0.01), and the provocation dose that caused a 20% fall in the FEV1 (PD20-FEV1) was significantly improved after one year of treatment. Conclusion: CTVA patients showed a good clinical response to anti-asthma treatments, and the treatment effects may be related to the severity of CTVA.