Severe Exacerbations and Decline in Lung Function in Asthma

O'Byrne, Paul M.; Pedersen, Søren; Lamm, Carl Johan; Tan, Wan C.; Busse, William W.

doi:10.1164/rccm.200807-1126oc

Cited by 409 publications

(335 citation statements)

References 21 publications

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“…In our study FEV 1 declined 17.4 ml/year faster, and FVC declined 14.3 ml/year faster in the low activity group. Sex (male), high frequency of disease exacerbations, old age, absence of glucocorticoid treatment, and smoking have been found to accelerate FEV 1 decline in asthmatics [9,36,37]. After adjusting for these factors with multiple linear regression analysis, the association of physical activity with FEV 1 decline remained significant.…”

Section: Discussionmentioning

confidence: 99%

Daily physical activity and lung function decline in adult-onset asthma: a 12-year follow-up study

Loponen

Ilmarinen

Tuomisto

et al. 2018

European Clinical Respiratory Journal

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Background: There is a lack of knowledge on the association between daily physical activity and lung function in patients with asthma. Objective: This study aims to examine the association between daily physical activity and asthma control, lung function, and lung function decline in patients with adult-onset asthma. Design: This study is part of Seinäjoki Adult Asthma Study (SAAS), where 201 patients were followed for 12 years after asthma diagnosis. Daily physical activity was assessed at follow-up by a structured questionnaire and used to classify the population into subgroups of low (≤240 min) or high (>240 min) physical activity. Three spirometry evaluation points were used: 1. diagnosis, 2. the maximum lung function during the first 2.5 years after diagnosis (Max0-2.5), 3. follow-up at 12 years. Results: High physical activity group had slower annual FEV1 (p<0.001) and FVC (p<0.018) decline. Additionally, the high physical activity group had higher FEV1 values at follow-up, and higher FEV1/FVC ratios at follow-up and diagnosis. There was no difference in BMI, smoking, medication, or frequency of physical exercise between high and low physical activity groups. Differences remained significant after adjustments for possible confounding factors. Conclusion: This is the first demonstration of an association between long-term FEV1 decline and daily physical activity in clinical asthma. Low physical activity is independently associated with faster decline in lung function. Daily physical activity should be recommended in treatment guidelines in asthma.

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Section: Discussionmentioning

confidence: 99%

Daily physical activity and lung function decline in adult-onset asthma: a 12-year follow-up study

Loponen

Ilmarinen

Tuomisto

et al. 2018

European Clinical Respiratory Journal

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“…Moreover, they attenuate the decline in lung function seen in association with severe exacerbations 86 . Fewer comparative studies have been conducted in children 5 years and younger.…”

Section: Inhaled Glucocorticosteroids and Cromolynmentioning

confidence: 99%

Global strategy for the diagnosis and management of asthma in children 5 years and younger

Pedersen

Hurd

Lemanske

et al. 2010

Pediatric Pulmonology

270

207

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Asthma is the most common chronic disease of childhood and the leading cause of childhood morbidity from chronic disease as measured by school absences, emergency department visits, and hospitalions1. During the past two decades, many scientific advances have improved our understanding of asthma and our ability to manage and control it effectively. However, in children 5 years and younger, the clinical symptoms of asthma are variable and non‐specific. Furthermore, neither airflow limitation nor airway inflammation, the main pathologic hallmarks of the condition, can be assessed routinely in this age group. For this reason, to aid in the diagnosis of asthma in young children, a symptoms‐only descriptive approach that includes the definition of various wheezing phenotypes has been recommended2. In 1993, the Global Initiative for Asthma (GINA) was implemented to develop a network of individuals, organizations, and public health officials to disseminate information about the care of patients with asthma while at the same time assuring a mechanism to incorporate the results of scientific investigations into asthma care. Since then, GINA has developed and regularly revised a Global Strategy for Asthma Management and Prevention. Publications based on the Global Strategy for Asthma Management and Prevention have been translated into many different languages to promote international collaboration and dissemination of information.In this report, Global Strategy for Asthma Management and Prevention in Children 5 Years and Younger, an effort has been made to present the special challenges that must be taken into account in managing asthma in children during the first 5 years of life, including difficulties with diagnosis, the efficacy and safety of drugs and drug delivery systems, and the lack of data on new therapies. Approaches to these issues will vary among populations in the world based on socioeconomic conditions, genetic diversity, cultural beliefs, and differences in healthcare access and delivery. Patients in this age group are often managed by pediatricians and general practitioners routinely faced with a wide variety of issues related to childhood diseases. Pediatr Pulmonol. 2011; 46:1–17. © 2010 Wiley‐Liss, Inc.

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“…In fact, exacerbations are the main cause of morbidity and mortality in patients with asthma [5], thus increasing the annual cost of treatment 3-fold [6]. Patients who have frequent exacerbations usually experience an accelerated loss of lung function [7].…”

Section: Introductionmentioning

confidence: 99%

Asthma exacerbations in a tertiary hospital: clinical features, triggers, and risk factors for hospitalization

Pola-Bibian¹,

Domínguez‐Ortega²,

Vilà-Nadal³

et al. 2017

J Investig Allergol Clin Immunol

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Background: The risk factors for asthma exacerbations are not fully understood. The aim of this study was to determine the epidemiological and clinical characteristics of patients who experience asthma exacerbations. We also assessed potential triggers of exacerbations and possible predictors of hospitalization. Methods: A retrospective, noninterventional cohort study was conducted in adult patients who attended the emergency department of a tertiary hospital with an asthma exacerbation during 2014.

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Severe Exacerbations and Decline in Lung Function in Asthma

Abstract: Severe asthma exacerbations are associated with a more rapid decline in lung function. Treatment with low doses of inhaled corticosteroid is associated with an attenuation of the decline.

Cited by 409 publications

References 21 publications

Daily physical activity and lung function decline in adult-onset asthma: a 12-year follow-up study

Daily physical activity and lung function decline in adult-onset asthma: a 12-year follow-up study

Global strategy for the diagnosis and management of asthma in children 5 years and younger

Asthma exacerbations in a tertiary hospital: clinical features, triggers, and risk factors for hospitalization

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