Introduction:Asthma is characterized by the presence of a reversible obstructive ventilatory disorder (OVD) after bronchodilators. A fixed OVD may be seen in some asthma patients. It is the result of histopathological changes in the bronchial structures. The aim of this work was to describe the clinical  characteristics of asthma patients with fixed OVD.

Methods : This was a cross-sectional study including asthma patients. The patients were divided into two groups :

 G1: patients with fixed OVD

 G2: patients with reversible OVD

Results:A total of 264 patients were included with a mean age of 42.3 years. A sex ratio was 0.6. Spirometry was normal in 33% of patients. The individualized respiratory functional disorders were: small airway disease (28%), fixed OVD (21%) and reversible OVD (18%). The comparative study showed that patients of G1 were older (49 vs 42 years), and had a higher smoking rate (60% vs 51%;p=0.05). Gastroesophageal reflux was more frequently observed in G1 (39% vs 30%, p =0,1). Asthma was predominantly allergic in both groups (70% vs 65%, p = 0.5). With regard to asthma severity, mean FEV1 was lower in G1 (65% vs 85%). Asthma control was better in G2 (40% controlled in G1 vs. 60% in G2, p=0.01). The mean number of asthma exacerbations per year was higher in G1 (2.1 vs 1.2). The number of patients with at least one exacerbation in the previous year was higher in G1 (70% vs 50%, p=0.03). The prescription of a combination of high-dose inhaled corticosteroids and long-acting bronchodilators was  more frequent in G1 (25% vs. 4%, p=0.03).

Conclusion:The presence of a fixed OVD in asthma patients is associated with more severe disease with more impaired lung function and poor asthma control.