Asthma Exacerbations Impact on Lung Function

Severe and recurrent exacerbations in patients with asthma are associated with more rapid lung function decline. To further characterize this patient population, researchers analyzed lung function, healthcare resource utilization (HCRU), and loss of productivity after exacerbations occurred.

In their study, published in the Journal of Asthma, they reported that patients had rapid lung function recovery after exacerbations, but function was not sustained and deteriorated more quickly than in patients without exacerbations.

Asthma Exacerbations Lead to Reduced Lung Function

This was a single-center, observational study with a prospective cohort of 102 US patients who presented to the authors’ center with an acute asthma exacerbation. An additional group of 48 patients without exacerbations was enrolled for comparison. Patients with exacerbations had a mean age of 42.7 ± 15.2 years and were 73% female, while the reference group had a mean age of 49.6 ± 12.4 and was 71% female.

Researchers reported lung function as forced expiratory volume in 1 second (FEV1) percent predicted (FEV1PP), and compared measurements taken at baseline, each day of month 1, and once during months 2 to 5. HCRU was evaluated as outpatient visits, emergency room visits, and hospitalizations. The authors also assessed oral corticosteroid use and asthma-related absences from work or school over 6 months.

The investigators observed that both groups had similar trends in FEV1, with a significant improvement from baseline at week 1 (P<.05), then a continuous decline. In the exacerbation group, FEV1PP at baseline and month 5 was 7.7% and 8.6% lower compared with the reference group.

In addition, patients with exacerbations had significantly higher oral corticosteroid prescription rates compared with the reference group (P=.04). The authors noted that 52.9% of patients with exacerbations experienced a recurrence during follow-up, as well as increased HCRU and impaired productivity.

In short, “the results suggest that intensive disease management and closer monitoring are important in patients with uncontrolled asthma experiencing exacerbations,” the investigators summarized.

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