European Respiratory Society
Annual Congress 2013
Abstract Number: 2751
Publication Number: P4177
Abstract Group: 5.2. Monitoring Airway Disease
Keyword 1: Asthma - management Keyword 2: Comorbidities Keyword 3: Inflammation
Title: Influence of obesity and nasal polyps on severe asthma
Dr. Federica 16454 Novelli f.c.78@libero.it MD 1, Dr. Giulia 16462 Lenzini giulia_lenzini@virgilio.it MD 1, Dr.
Manuela 16465 Latorre manuela.latorre@yahoo.it MD 1, Dr. Veronica 16486 Seccia
veronicaseccia@gmail.com MD 2, Dr. Maria Laura 16496 Bartoli m.bartoli@ao-pisa.toscana.it MD 1, Dr.
Laura 16506 Malagrinò lauramalagrino@yahoo.it MD 1, Dr. Federico Lorenzo 16508 Dente
f.dente@ao-pisa.toscana.it MD 1 and Prof. Pier Luigi 16512 Paggiaro lpaggiaro@dcap.med.unipi.it MD 1. 1
Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Italy and 2
ENT Unit, University of Pisa, Pisa, Italy .
Body: Background: Asthma is often associated with comorbidities that can influence its control, phenotype
and response to treatment. Aim of this study is to evaluate the influence of two common comorbidities
(obesity and nasal polyps, NP) on pulmonary function, inflammation, asthma control and quality of life in
patients with severe asthma (SA). Method: We studied 64 patients with SA. All patients performed
spirometry, collection of induced sputum for inflammatory cells, measurement of exhaled nitric oxide (eNO)
and ENT visit. Asthma control was evaluated according to GINA guidelines and by ACT questionnaire,
quality of life by AQLQ. Results: The percentage of patients with uncontrolled asthma was high (46.9%).
Obese asthmatics had a similar functional data than non-obese, but worse asthma control (ACT score: 16
(7-25) vs 21 (10-25), p<0.05; poorly controlled: 71,4% vs 34,9%, p<0.05) and quality of life index (AQLQ
score: 4.5 (3.0-6.2) vs 5.1 (2.7-6.7), p<0.05), as well as a trend to have lower sputum eosinophilia (6.6
(0-71.2) vs 17.6 (0-95.6), p=0,07), with no-difference in asthma treatment. Asthmatics with NP showed
similar asthma control and quality of life index than asthmatics without NP, but worse spirometry (FEV1
71.1±16.7 vs 81.0±17.3, p<0.05) and higher sputum eosinophilia (29.8 (0.4-95.6) vs 8.5 (0-84.1), p<0.05).
In a multivariate analysis taking into account age, sex, FEV1 (% of predicted), obesity, NP and sputum
eosinophilia, only the obesity predicted the lack of asthma control (OR: 5.6, CI: 1.4-22.8 p=0.01).
Conclusion: In patients with SA, NP is associated with increased eosinophilic airway inflammation and with
worse lung function, but has less impact on asthma control and quality of life than obesity.