Outcome of asthma: longitudinal changes in lung function

Abstract

Current knowledge about factors determining outcome of asthma is limited, but observations over the last few decades suggest that active asthma has a negative impact on the longitudinal changes in lung function. This review aims to give an overview of the present knowledge concerning longitudinal changes in lung function, including clinical markers for distinctly poor outcome with regard to lung function, in children and adults suffering from asthma. The majority of patients with asthma have a good prognosis. However, some patients with asthma, especially those with more severe disease, are at risk of impaired growth of lung function during childhood, a lower maximally attained level of lung function and excessive decline in lung function in adulthood, which may lead to life‐threatening lung function impairment. Clinical markers of poorly controlled airway inflammation appear to have a negative impact on the longitudinal changes in lung function, and disease progression to nonreversible airflow obstruction may be observed in a minority of patients with asthma. Early intervention with anti‐inflammatory therapy may improve the short‐term outcome of asthma, but long‐term controlled studies are clearly needed in order to verify whether or not treatment, especially with inhaled corticosteroids, according to the current international guidelines alters the natural history of asthma, i.e. disease progression with regard to changes in lung function and possible development of nonreversible airflow obstruction.

Comparative efficacy of inhaled ciclesonide, budesonide, and fluticasone in mild to moderately persistent bronchial asthma

“…But at the end of 6 th month, there was a marked improvement in PFER seen in all the three groups. [9][10][11][12] Initially, the mean FEV1% predicted was 64.1%, 60.1%, and 60.5% for the groups put on ciclesonide, budesonide, and fluticasone, respectively, and the percentage of improvement after bronchodilatation was 20%, 19%, and 21%, respectively, which markedly improved after 6-month treatment and is comparable to the study under taken by Burke et al 1991. 13 Thus, showing significant improvement in the mean values at the end of the treatment, which is comparable to the study by Buhl et al (2006).…”

Determinants of persistent asthma in young adults

“…individuals with asthma at baseline had quit smoking earlier or had never started smoking due to airway symptoms since no difference between persistent asthma and remission was found among the individuals who ceased smoking during follow up. Previous studies have suggested that smoking may have a negative effect on longitudinal changes in lung function in individuals with asthma [31]. A recent large study on asthma in the general population aged 20–100 years showed that smoking was the main explanation of poor prognosis and comorbidities in individuals with asthma during 4.5 years of follow up [32].…”

Guía Mexicana del Asma: GUIMA 2017

“…Désirée Larenas-Linnemann, 1 Jorge Salas-Hernández, 2 Juan Carlos Vázquez-García, 3 Ignacio Ortiz-Aldana, 4 Margarita Fernández-Vega, 5 Blanca Estela Del Río-Navarro, 6 María del Carmen Cano-Salas, 7 Jorge Agustín Luna-Pech, 8 José Antonio Ortega-Martell, 9 Jade Romero-Lombard, 10 Erika del Carmen López-Estrada, 11 Jimena Villaverde-Rosas, 12 José Luis Mayorga-Butrón, 13 Mario Humberto Vargas-Becerra, 14 Martín BedollaBarajas, 15 Noel Rodríguez-Pérez, 16 Ambrocio Aguilar-Aranda, 17 Carlos Adrián Jiménez-González, 18 Carlos García-Bolaños, 19 Claudia GarridoGalindo, 20 David Alejandro Mendoza-Hernández, 21 Enrique Mendoza-López, 22 Gerardo López-Pérez, 21 Guillermo Hideo Wakida-Kuzonoki, 23 Héctor Hernán Ruiz-Gutiérrez, 24 Héctor León-Molina, 25 Héctor Martínez-De la Lanza, 26 Héctor Stone-Aguilar, 27 Javier Gómez-Vera, 28 Jorge…”