Obesity Clinical Trial
Official title:
Obesity-related Pseudo-asthma (ORPA): Description of a Novel Clinical Entity
Clinicians frequently observed that obese women referred for severe asthma do not respond to
treatment. These patients, despite the presence of wheezing, often have normal expiratory
flows and normal or "borderline" airway responsiveness.
It is therefore possible that this mode of presentation reflect a pseudo-asthmatic state for
which clinical definition and characteristics and optimal management remain to be
determined.
The aim of this study was to study the pulmonary physiological and airway inflammatory
characteristics and response to treatment of obese women considered to have clinically
severe asthma in order to demonstrate that some of these patients have a phenotype that is
not that of asthma.
Twenty-five obese women (BMI over 30) and 25 non-obese women (18>BMI<25) considered to have
severe asthma by their physician and requiring corticosteroids to control their asthma will
have the following investigation:
- Respiratory questionnaires focussing on the nature and time-course of symptoms, asthma
control criteria, medication use.
- Physical examination, including measures of BMI, waist, hips and ratio waist/hips
- Blood test for Complete Blood Count, blood glucose, total IgE levels and markers of
systemic inflammation (C-Reactive Protein, fibrinogen…)
- Spirometry and bronchodilator response.
- Induced sputum analysis and Exhaled Breath Condensate pH to assess airway inflammation.
- Skin prick tests with a battery of common airborne allergens
- Measurement of lung volumes and airway resistance + MIP and MEP.
- Methacholine challenge (up to 16 mg/ml) with Borg scores for breathlessness and chest
tightness.
;
Observational Model: Case Control, Time Perspective: Cross-Sectional
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