Changes in symptoms (ACQ, ACT, AQLQ), lung function (morning PEF, FEV1), airway hyper-responsiveness (PC20AMP) and airway inflammation (Feno) in eosinophilic asthma (EA) and non-eosinophilic asthma (NEA) after inhaled fluticasone (1000 μg daily) given for 28+ days
| All (n=88) | EA (n=60) | NEA (n=28) | |||||||||
| Before | After | Δ | p Value | Before | After | Δ | Before | After | Δ | p Value (treatment effect in EA vs NEA) | |
| ACQ | 1.6 (0.9) | 0.7 (0.6) | −0.9 (0.9) | <0.001 | 1.9 (0.9) | 0.7 (0.6) | −1.1 (0.9) | 1.0 (0.6) | 0.7 (0.5) | −0.3 (0.5) | <0.001 |
| ACT | 18 (4) | 21 (3) | 3 (4) | <0.001 | 17 (4) | 21 (3) | 4 (4) | 20 (4) | 21 (3) | 1 (3) | 0.011 |
| AQLQ | 5.7 (0.9) | 6.4 (0.6) | 0.7 (0.8) | <0.001 | 5.5 (1.0) | 6.4 (0.6) | 0.9 (0.9) | 6.2 (0.6) | 6.4 (0.6) | 0.2 (0.4) | 0.012 |
| am PEF (l/min) | 376 (98) | 415 (117) | 10 (10)* | 0.132 | 372 (95) | 416 (116) | 12 (10)* | 390 (108) | 410 (125) | 5 (8)* | 0.583 |
| FEV1 (l) | 2.36 (0.83) | 2.86 (0.83) | 26 (25)* | 0.002 | 2.22 (0.78) | 2.85 (0.80) | 34 (26)* | 2.68 (0.86) | 2.87 (0.90) | 7 (7)* | 0.094 |
| PC20AMP (mg/ml)† | 18.7 (11.8 to 29.6) | 157.4 (100.9 to 245.5) | 3.1 (2.9)‡ | <0.001 | 10.2 (6.0 to 17.4) | 141.9 (80.9 to 248.9) | 3.8 (3.0)‡ | 53.9 (26.9 to 108.0) | 188.5 (90.3 to 393.7) | 1.8 (2.2)‡ | 0.036 |
| Feno (ppb)† | 44.2 (37.8 to 51.5) | 20.6 (18.3 to 23.1) | −25.1 (−57.9, −6.0)§ | <0.001 | 55.2 (46.6 to 65.4) | 21.6 (18.8 to 24.9) | −35.9 (−62.5, −15.4)§ | 27.7 (21.7 to 35.2) | 18.5 (15.2 to 22.6) | −7.3 (−19.0, −0.7)§ | 0.007 |
Presented as mean (SD) unless otherwise stated. Changes (Δ) expressed as: absolute changes for ACQ, ACT, AQLQ and Feno.
↵* Percentage changes for PEF and FEV1.
↵† Analysed after logarithmic transformation and results presented as geometric mean (95% CI).
↵‡ Doubling dose changes for PC20AMP. Analysed using mixed model analysis.
↵§ Change (Δ) in Feno presented as median (interquartile range).
ACQ, Asthma Control Questionnaire; ACT, Asthma Control Test; AQLQ, Asthma Quality of Life with Standardised Activities; am PEF, morning peak flow rate; FEV1, forced expiratory volume in 1 s; PC20AMP, provocation concentration of adenosine monophosphate causing a 20% fall in FEV1; Feno, fraction of exhaled nitric oxide.