Therapeutic Response of Patients with Chest Tightness Variant Asthma: 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. Methods: To explore the clinical course and response of 96 CTVA patients to standard asthma treatments with inhaled corticosteroids with long-acting beta-agonists in a 52-week multicenter, prospective, real-life study. Findings: After 52 weeks of treatment with therapy regimens used for CA, the 5-point Asthma Control Questionnaire (ACQ-5) scores decreased markedly from 1·34±0·88(before treatment; V0) to 0·97±0·70 (4 weeks, V1), 0·83±0·72 (13 weeks, V2), 0·73±0·76 (26 weeks, V3), and 0·76±0·79(52 weeks, V4) ( P <0·01), while the Asthma Quality of Life Questionnaire (AQLQ) scores increased from 5·76±0·76 (V0) to 6·24±0·60(V3) and 6·14±0·60(V4) ( P <0·01). The Self-rating Anxiety Scale(SAS) score improved as evidenced by a decrease from 41·44±10·24 (V0) to 37·61±11·41 (V2) and 37·67±8·07 (V4) ( P <0·01). Diurnal variation in peak expiratory flow (PEF) and the bronchial provocation test were improved at one year. However, forced expiratory volume (FEV1) andnitric oxide levels in exhaled breath (FeNO) showed no improvement. Interpretation  CTVA patients showed a good clinical response to anti-asthma treatments, and the treatment effects may be related to theseverity of CTVA. Interpretation: CTVA patients showed a good clinical response to antiasthma treatments, and the treatment effects may be related to the severity of CTVA. Trial Registration: ClinicalTrials.gov identifier: NCT 03237221 Funding: 1.This study was supported by the Zhejiang Medical and Health Science and Technology program from Health Commission of Zhejiang Province (WKJ2014-ZJ-01412). 2.This work was funded by the Precision Medicine Research of The National Key Research and Development Plan of China (2016YFC0905800). 3.This study was supported by the program for the Key Site of National Clinical Research Center for Respiratory Disease, the Key ScienceTechnology Innovation Team of Zhejiang Province (2011R50016). Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The study was approved by the Institutional Review Board for Human Studies of Second Affiliated Hospital of Zhejiang University School of Medicine (Hangzhou, China).