Asthma exacerbations are associated with faster lung function decline, particularly in younger patients, the largest study of its kind confirms.
The findings highlight the “potential value” of addressing exacerbation burden when patients are still in the growth and plateau phases of lung trajectory before 40 years of age, the UK researchers say.
The study involved over 100,000 asthma patients from the Optimum Patient Care Research Database who were followed for up to 60 years and had more than three eligible post-18th birthday peak expiratory flow (PEF) rate or forced expiratory flow in 1 second (FEV₁) records.
The research team found that the greater the annual exacerbation rate, the lower the starting lung function and the more negative the trajectory over time.
After adjusting for confounders, for each additional exacerbation an estimated additional −1.34 L/min PEF per year were lost. Patients with annual exacerbation rates (AERs) >2/year and aged 18–24 years at baseline lost an additional −5.95 L/min PEF/ year compared with those who had no exacerbations.
“This association and speed of lung function decline were stronger in younger patients aged 18–39 years, persisted even in patients on higher average daily inhaled corticosteroid doses and was consistent for trajectories based on either PEF or FEV1,” the study authors wrote in their paper published in Thorax.