Phenotyping Post TB Obstructive airways disease (TOPD) in India

Abstract

Aims and Objectives: To study the characteristics, severity of airflow limitation and prescription pattern in TOPD patients in India.

Introduction: There is a paucity of data reported from India on the TOPD phenotype and understanding of the disease process.

Methods: A semi-structured questionnaire was prepared by Respiratory Research Network of India and was filled by the investigator at the study sites across India.

Results: 103 patients were identified as having post TOPD 9 (8.7%) had mild disease, 39 (37.9%) had moderate, 37 (35.9%) severe and 18 (17.5%) were diagnosed as very severe TOPD. Significant negative correlation (r= -0.499, p value =0.021) was observed between duration of TOPD and patients with severe TOPD. The Pearson Chi square test showed a significance association (p value=0.033) between occurrence of post-TOPD and affected left middle zone. Reversibility was observed in 24 (23.3%) patients and fixed airflow obstruction was observed in 79 (76.7%) patients respectively. Prescription pattern showed that, LAMA alone was prescribed to 5 (5%), LABA and LAMA combination to 10 (10%), LABA and ICS combination to 20 (20%), LAMA and ICS to 5 (5%), LAMA, LABA and ICS combination to 60 (60%) cases. Mild disease was most commonly prescribed with LABA+ICS (66.66 %), moderate with LAMA+LABA+ICS (77%), severe with LABA+ICS (32.35%) and very severe cases with LAMA+LABA+ICS (83.3%). %). Hence the treatment regime was not in accordance with the GINA or GOLD guidelines.

Conclusion: The current study emphasis on the importance of screening of post-TOPD. This study presented the association of post-TOPD on the lung function and the prescription pattern currently followed for the treatment of post-TOPD.