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The first year of treatment predicts the prognosis of asthma over 25 y—A prospective study
Author(s) -
Kauppinen Ritva,
Vilkka Vesa,
Sintonen Harri,
Hedman Jouni
Publication year - 2020
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/all.13983
Subject(s) - medicine , asthma , quality of life (healthcare) , lung function , pulmonary function testing , pediatrics , prospective cohort study , lung , nursing
Background An investigator‐driven, real‐life follow‐up study of adult‐onset steroid‐naïve, newly diagnosed asthma (162 patients) to investigate the treatment results over the 25‐year course of the disease and whether the first treatment year's forced expiratory volume in one second (FEV 1 ) predicts the long‐term prognosis. Methods Eighty‐three per cent of the 133 living patients participated in the 25‐year examinations. At this visit, basic asthma examinations including lung function, as well as questionnaires for health‐related quality of life (HRQoL), GINA and the Asthma Control Test, were used for evaluation. The use of medication and remission was verified. Results There was no statistically significant change in mean FEV 1 % predicted (FEV 1 %) from baseline to the 25‐year control. The changes in FEV 1 % during the first year predicted the results at the end of follow‐up. Normal FEV 1 % at the end of the first year predicted normal FEV 1 , and below‐normal FEV 1 % at 1 year predicted below‐normal FEV 1 % at 25 years. Twenty‐nine patients (26.4%) had discontinued their medication, and six (5.5%) used ICS periodically. Clinical remission was reached by 16.4% of the patients, and 7.6% reached functional remission. The general HRQoL remained unchanged. Conclusion In adult‐onset asthma, the level of FEV 1 reached during the first treatment year seems to predict the later lung function level. One quarter of the patients discontinued the asthma treatment, but their HRQoL was better than that of those continuing to use ICS. Clinical remission was reached by 16% of the patients, which is in concordance with other studies.