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Inducible laryngeal obstruction causes significant morbidity and healthcare use, based on the first multicenter prospective patient characterization.

Inducible laryngeal obstruction (ILO) is due to inappropriate laryngeal closure during breathing which causes airflow obstruction at the glottic or supraglottic level and results in breathlessness. Previously, limited information was available on the demographics and impact of ILO. In a recent study, researchers sought to report the clinical and demographic characteristics of patients with ILO who were prospectively enrolled in the UK national ILO registry.

“Despite distinct pathophysiology, the presentation of ILO may appear similar to that of asthma and many patients are initially misdiagnosed and managed as such,” wrote the study authors. “Furthermore, the relationship between asthma and ILO is complex, and the two conditions are not always mutually exclusive.”

“Several studies indicate that ILO is a prevalent comorbidity in approximately one-third of people with asthma.”

For the current study, which was published online in The Journal of Allergy and Clinical Immunology: In Practice, participants with endoscopically confirmed ILO, attending four specialized ILO centers across the UK, were enrolled into a web-based registry from March 2017 to November 2019.

The study included data from 137 participants. Most (87%) exhibited inspiratory ILO, requiring provocation during endoscopy to elicit symptoms. There was a predominance of females (80%) with a mean age of 47 (SD, 15 years). Common comorbidities included asthma (68%) and reflux (57%).

Healthcare utilization was high with 88% of participants reporting emergency healthcare services due to symptoms at least once in the past year, and nearly half had been hospitalized. One-fifth had required critical care admission due to ILO symptoms. Significant morbidity was reported, with 64% experiencing impaired functional capacity (≥3 on the Medical Research Council Dyspnoea Scale) and one-third reporting that symptoms affected their ability to work.

This study provided the first multicenter prospective characterization of patients with endoscopically diagnosed ILO. The findings revealed that ILO was associated with substantial morbidity and high healthcare utilization, comparable to severe asthma.

“Analysis of our multicenter data set identified ILO as associated with a high burden of morbidity and healthcare use, comparable to severe asthma,” the authors concluded.

“These data will support the development of healthcare resources in the future and guide research priorities.”