Source: International Congress 2016 – Asthma: mechanisms and biomarkers that promote clinical understanding
Disease area: Airway diseases

Abstract

Background: Predictors of long-term lung function decline in adult-onset asthma are not known.Aims: To evaluate the determinants for accelerated loss of lung function in a 12-year follow-up as a part of Seinäjoki Adult-onset Asthma Study (SAAS).Methods: 257 adults were diagnosed with new-onset asthma during 1999-2002. After 12 years patients (n=203) were re-evaluated. Spirometry measurement points were:1.) baseline (i.e. time of diagnosis), 2.) the maximum lung function (Max_0-2.5) during the first 2.5 years after diagnosis (i.e. after start of therapy) and 3.) after 12 years of follow-up. The predictors of annual FEV₁ decline between Max_0-2.5 and follow-up were assessed by multiple linear regression analysis.Results: The predictors of lung function decline are presented in Table1.

Table 1. Predictors of annual FEV₁ decline (mL) from Max_0-2.5 to follow-up in multiple linear regression analysis. n=155

Variable	Estimate (DmL)	95% CI	P-value
DBMI (Max0-2.5-follow-up) kg/m2	-1.52	-3.00 to -0.03	0.046
Age at follow-up	-0.33	-0.63 to -0.02	0.036
Female gender	5.00	-3.95 to 13.95	0.272
>10 pack-years at follow-up	-13.06	-22.56 to -3.55	0.007
LOG B-eos at follow-up	-15.34	-29.09 to -1.59	0.029
DFEV₁ %predictedW (baseline-Max0-2.5)	-0.04	-0.05 to -0.03	0.000
FEV₁ %predictedW at baseline	-0.44	-0.72 to -0.16	0.002
Not daily ICS user at follow-up	-0.84	-11.04 to 9.37	0.170
FeNO >20ppb at follow-up	-13.65	-23.42 to -3.89	0.006

 

Conclusion: Smoked pack-years >10, increased age, weight gain and ongoing inflammation predict accelerated loss of lung function in adult-onset asthma. Interestingly, good initial response to anti-inflammatory therapy may indicate also accelerated decline in FEV₁ later on.
W:pre bronchodilator

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Citations should be made in the following way:
Minna Tommola (Seinäjoki, Finland), Minna Tommola, Pinja Ilmarinen, Leena Tuomisto, Jussi Haanpää, Terhi Kankaanranta, Onni Niemelä, Hannu Kankaanranta. Predictors of long-term lung function decline in adult-onset asthma. Eur Respir J 2016; 48: Suppl. 60, 566

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