Any role for cardiopulmonary exercise test as an outcome in severe asthmatic patients after the initiation of biological therapy?

Abstract

Introduction: Severe asthmatic patients(SAP) show a reduced exercise capacity,with a likely role of deconditioning and a reduction of daily physical activity(DPA).We hypothesised that oxygen uptake at peak exercise(peakVO2) measured through cardiopulmonary exercise testing(CPET) could be used as outcome for the assessment of SAP after introduction of biological therapy. Aims and objectives: Our primary objective was to assess exercise capacity in SAP in a clinical context before and 16weeks after introduction the biological therapy, as proposed in a previous study on Omalizumab(Schaper C.et al,Respir Med 2011).We also evaluated changes in DPA and quality of life after therapy. Material and methods: We enrolled 11 severe asthmatic patients with the indication to the biological therapy. The following tests were conducted before the first administration of the biological and after 16weeks: -Pulmonary function tests -CPET -Asthma Quality of Life Questionnaire -Stepcount (measured by metabolic monitor) Results: There were no significant differences in our outcomes 16weeks after starting therapy(tab.1) Conclusion: Our data suggest that these CPET and DPA variables are not relevant outcomes to monitor the efficacy of biological drugs in SAP,probably due to the short time after the first assessment and possibly to a poor engagement of patients in increasing these specific aspects.More conclusive data would come from extending evaluation 52 weeks after the start of therapy.