Background: Asthma-like symptoms and bronchial responsiveness to bronchodilators in cystic fibrosis (CF) are associated with decreased and more rapid decline in FEV1.
Aims: To assess the prevalence of asthma and associated characteristics, as well as frequency of bronchodilator usage and its relationship to asthma in CF.
Methods: Patients with CF followed at the Schneider CF Center (n=100) and Hadassah University Hospital (n=77) were retrospectively studied.
Results: Among the 177 patients, 50% had > 10% increase in FEV1% and 41% had > 30% increase in MEF25-75% after bronchodilators, demonstrating reversible airways obstruction. No difference was found between pancreatic sufficient (PS) and insufficient (PI) patients or in those with asthma in 1st degree family members, high serum Ig-E levels or eosinophilia. There was also no change in airways reversibility in those with aspergillus or chronic pseudomonas infection. Seventy-one percent of patients with ABPA showed airway reversibility (p=0.08). At Schneider’s, younger age correlated with reversible obstruction (p=0.001). Seventy-two percent of patients with airway reversibility were treated with bronchodilators; however, 44% of all patients using bronchodilators did not have airway reversibility.
Conclusions: Reversible airway narrowing is a common finding in CF, more frequent at a younger age and in patients with ABPA. Interestingly, there was no correlation with markers of asthma and atopy or disease severity as expressed by pancreatic function. Bronchodilators are commonly prescribed in CF, even in those without reversibility of airway obstruction.
