Bronchodilator response as a marker of poor asthma control

Background: Asthma guidelines emphasise the importance of monitoring disease control in managing asthma. Objective: The aim of this study was to evaluate the relationship between lung function, including bronchodilator response in terms of improving in FEV1 after administration of salbutamol, and asthma control. Methods: 246 patients with known asthma and in regular chronic treatment according to international guidelines were consecutively enrolled in a 12 month-period. All patients were evaluated by asthma control test (ACT), spirometry and bronchodilator test with salbutamol 400 mcg. Results: Mean ACT value was 18.8. Patients with significant bronchial reversibility had lower ACT mean values. This finding was confirmed in both patients with airway obstruction and in those with normal spirometry. There was a significant correlation between ACT values and bronchodilator response. Conclusions: The persistence of a significant degree of bronchodilator response despite regular treatment according to guidelines was a marker of worse asthma control. Clinical implications: Bronchodilator response, correlating with worse asthma control even in patients with normal spirometry, should be test at every visit as it may add information on asthma control.