Lung function impairment increases with age of diagnosis in adult onset asthma

Porsbjerg, Celeste; Lange, Peter; Ulrik, Charlotte Suppli

doi:10.1016/j.rmed.2015.04.012

Cited by 35 publications

(28 citation statements)

References 29 publications

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“…This is exactly the same number as was found in the Copenhagen City Heart Study. [23] The lung function in these patients is also similar to that found in the study by Porsbjerg et al,[23] i.e. about 80%.…”

Section: Discussionsupporting

confidence: 88%

Undiagnosed chronic obstructive pulmonary disease in patients admitted to an acute assessment unit

Eikhof

Olsen

Wrengler

et al. 2017

European Clinical Respiratory Journal

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Introduction: Chronic obstructive pulmonary disease (COPD) is very prevalent worldwide, yet underdiagnosed. Aim: This study investigates feasibility of performing spirometry in patients in need of acute hospital admission as well as the prevalence of undiagnosed COPD in the same cohort. Methods: During a two-week period, all patients admitted to three large acute assessment units were evaluated. Patients ≥ 18 years, able to perform spirometry, with no surgery to the thorax or abdomen within the last weeks and no known COPD was included. Patients with FEV1/FEV6 ≤ 0.7 or FEV1 < 80% or FEV6 < 80% were offered follow-up visit after 6 weeks. Results: Of the 1145 admitted patients, 46% were eligible: 28% of those had an abnormal spirometry. The offered follow-up visit was attended by 51% and in this group 17% were diagnosed with lung disease. COPD was the most prevalent diagnosis (73%), and 2/3 was in GOLD group A. In total, 75% of the patients with airflow obstruction at the initial examination remained obstructive. Conclusion: Performing spirometry in patients in need of acute hospital admission is feasible, abnormal findings are common, and COPD is the most prevalent diagnosis.

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Section: Discussionsupporting

confidence: 88%

Undiagnosed chronic obstructive pulmonary disease in patients admitted to an acute assessment unit

Eikhof

Olsen

Wrengler

et al. 2017

European Clinical Respiratory Journal

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“…43 In that study, the proportion of newly diagnosed asthma was same in all the age groups: 7% at age >64 years, 7% at age 35-64 years and 6% at age <35 years. 43 As early as 1999, Davies et al reported a correlation between DL CO and response to ICS in COPD. 44 We believe that CT scan and KCO are the ideal techniques for phenotyping.…”

Section: Discussionmentioning

confidence: 70%

“…The Copenhagen City Heart Study reported on newly diagnosed asthma during a 10‐year follow‐up in a sample comprising 4983 individuals . In that study, the proportion of newly diagnosed asthma was same in all the age groups: 7% at age >64 years, 7% at age 35–64 years and 6% at age <35 years …”

Section: Discussionmentioning

confidence: 99%

Can computed tomography and carbon monoxide transfer coefficient diagnose an asthma‐like phenotype in COPD?

et al. 2016

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“…Late onset, highlighted as a risk factor for accelerated decline by some authors, was not confirmed by our analysis. These inconsistencies can be explained by the difference in late onset definition varying from 18 years old to an onset during the time of study [9,12,50] or the possible misclassification of asthmatics in these studies due to self-reported diagnostic [9,12].…”

Section: Discussionmentioning

confidence: 95%

“…Nevertheless, not all asthma patients decline over time, some show stable lung function and some others can outgrow their asthma disease [5]. Previous studies have revealed risk factors for accelerated FEV 1 decline in asthma: low baseline lung function (FEV 1 % predicted) [6,7], airway hyper-responsiveness [8], male gender [9], cigarette smoking [10,11], late asthma onset [12], duration of disease [4], frequent and severe exacerbations [13]. Moreover, the role of inflammation and eosinophilia in lung function decline has been highlighted with high eosinophil sputum numbers [5], high variability in sputum eosinophils [14], as well as higher blood eosinophil numbers [15] linked to accelerated rate of lung function decline in asthma.…”

Section: Introductionmentioning

confidence: 99%

Increase in blood eosinophils during follow-up is associated with lung function decline in adult asthma

Graff

Demarche

Henket

et al. 2019

Respiratory Medicine

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A B S T R A C TBackground: Asthma is associated with accelerated rate of lung function (FEV 1 ) decline. Objective: To determine predictive factors associated with FEV 1 decline in adult asthma. Methods: A retrospective study was conducted in 229 asthmatics recruited from the University Asthma Clinic of Liege. Subjects had at least two visits with post-bronchodilation (post-BD) FEV 1 and minimum one year between them. A multivariable linear regression analysis was conducted in order to come up with factors associated with lung function decline. Results: Post-BD FEV 1 decline in % predicted. y −1 was 0.2 (95%CI -2.0 to 2.8) in the overall population. Our population was made up of mild to moderate asthmatics [1] for 58%, aged 50 (41-60) years old, 62% were female and 59% were atopic. Median ICS dose was 1000 μg beclomethasone equivalent (CFC)/day with 81% treated at baseline. Time between visits was 46.8 ± 32.1 months. The univariate linear regression analysis revealed a negative association between % predicted FEV 1 decline and baseline ACQ (p < 0.0001) and blood eosinophils (% and/mm 3 ) (p < 0.0001 and p < 0.0001). A positive association was found between % predicted FEV 1 decline and baseline pre-BD FEV1 (mL) values (p = 0.001), blood neutrophils (%) (p = 0.02), change in blood eosinophils (%) (p < 0.0001), time between visits (months) (p < 0.0001). The predictive variables for accelerated decline highlighted by the multivariable analysis (r 2 = 0.39) were change in blood eosinophils (%) over time (p = 0.002) and time between visits (months) (p < 0.0001). Conclusion: These findings highlight a new value for blood eosinophil counts as their increase over time predicts greater lung function decline in asthma. Methods Study design, setting and participants

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Lung function impairment increases with age of diagnosis in adult onset asthma

Cited by 35 publications

References 29 publications

Undiagnosed chronic obstructive pulmonary disease in patients admitted to an acute assessment unit

Undiagnosed chronic obstructive pulmonary disease in patients admitted to an acute assessment unit

Can computed tomography and carbon monoxide transfer coefficient diagnose an asthma‐like phenotype in COPD?

Increase in blood eosinophils during follow-up is associated with lung function decline in adult asthma

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