An update on oscillometry in asthma

Abstract

Introduction: Notwithstanding considerable progress in asthma management, a significant proportion of patients continue to demonstrate suboptimal control. Research has identified small airways dysfunction (SAD) as a critical site for airflow limitation and an independent risk factor of exacerbations, with airway oscillometry (AO) playing a pivotal role in this field.

Areas covered: Spirometry is widely accepted as the gold standard for evaluating respiratory function. However, it is primarily sensitive to large airway obstruction… AO has emerged as a valuable tool for quantifying SAD, and recent studies have established strong correlations between AO, advanced imaging techniques and type 2 biomarkers. We conducted a review of the English-language literature from the beginning of the databases reviewed through June 2025.

Expert opinion: In recent years, a substantial body of literature has emerged, leading to a resurgence of interest in the role of AO in asthma management. It is recommended that AO be utilized as a primary diagnostic tool for the early detection of SAD, even when spirometric values are within normal limits. The identification of patients with asthma in accordance with the criteria of defined severe SAD-oscillometry signifies the culmination of the evolution of AO from a research tool to a clinical tool.

Keywords: FOT; IOS; Severe asthma; biologics; oscillometry; small airways dysfunction; spirometry.