A study in this week’s NEJM adds to a growing body of evidence linking childhood asthma to the development of COPD in early adulthood.
The CAMP study of 684 children with persistent asthma discovered that by early adulthood three-quarters of the participants displayed an early decline in lung function and/or reduced lung growth.
At the end of the study 11 percent met the Global Initiative for Chronic Obstructive Lung Disease spirometric criteria for lung-function impairment that was consistent with COPD.
These participants were more likely to have a reduced pattern of growth than a normal pattern (18% vs. 3%, P<0.001), the study showed.
Impaired lung function at enrolment and male gender were the most significant predictors of abnormal longitudinal patterns of lung-function growth and decline.
Senior author Robert C Strunk* a professor of paediatrics at Washington University School of Medicine described the findings as ‘astonishing’.
“For people barely into adulthood to already have COPD is terrible. As the COPD evolves, they are likely to have health problems that will make it difficult to participate in normal day-to-day responsibilities such as holding a job,” he said.
One of the paper’s senior authors Scott Weiss said the findings showed the importance of physicians identifying at-risk children earlier.
“Since asthma itself is a risk factor for developing COPD, these patients should be advised against risk related environmental exposures, like smoking, that could intensify their symptoms and increase their COPD risk,” said Weiss.
“It is important that we recognize this link between persistent childhood asthma and COPD as a potential problem and focus on prevention efforts.”
*Sadly Professor Strunk unexpectedly passed away on April 28.