Asthma diagnosis and treatmentInhaled steroids are associated with reduced lung function decline in subjects with asthma with elevated total IgE
Section snippets
Study design
The ECRHS is an international multicenter study of asthma. The first survey19 was performed from 1991 to 1993 on random community-based samples of adults age 20 to 44 years. Each participant was sent a brief questionnaire (stage 1) and, from those who responded, a 20% random sample was invited to undergo a more detailed clinical examination (stage 2). In addition, a symptomatic sample consisting of those who reported symptoms of waking with shortness of breath or asthma attacks in the last 12
Comparison between included and excluded subjects
Table I describes the main baseline features of the subjects included and not included in the analysis. The latter are either nonparticipants in the ECRHS II, or participants whose FEV1 was unavailable, not in agreement with the ATS criteria, or measured within 12 hours after the last administration of a LABA. Subjects included in the analysis were slightly older and had a lower percentage of current smokers (30% vs 39%) and of manual workers than subjects who were excluded. On average, among
Discussion
In a large community-based sample of subjects with asthma from the general population, followed up for 9 years, we have shown that a lower decline in FEV1 was associated with a prolonged use of inhaled steroids. This association was only observed in those with elevated total IgE levels. There was a dose-response relationship, with lower decline in those who had used inhaled steroids for the longest periods. The association was found in men and in women, as well as in smokers and in nonsmokers.
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2020, Journal of Allergy and Clinical Immunology: In PracticeEffect of omalizumab on lung function and eosinophil levels in adolescents with moderate-to-severe allergic asthma
2020, Annals of Allergy, Asthma and ImmunologyCitation Excerpt :Longer-term studies are required to determine how this impacts lung function in adulthood. Eosinophilic airway inflammation also has been associated with lung function decline,37 with treatment of eosinophilic airway inflammation using corticosteroids being shown to reduce the rate of lung function decline from 34 to 20 mL/year over 4 years of treatment.38 Omalizumab specifically targets Th2 inflammation and has been shown to reduce eosinophil counts in blood and sputum39-41 and to reduce interleukin 5 secretion by mononuclear cells.41
Can inhaled corticosteroids modify the natural history of asthma in children?
2016, Revue Francaise d'AllergologieFactors contributing to an accelerated decline in pulmonary function in asthma
2014, Allergology InternationalIncreased periostin associates with greater airflow limitation in patients receiving inhaled corticosteroids
2013, Journal of Allergy and Clinical ImmunologyMental health among adults with asthma and chronic bronchitis. A population-based study in Spain
2012, Respiratory MedicineCitation Excerpt :This hypothesis has been suggested by Sundberg et al.,30 after detecting that women begin to show asthma symptoms later and have a less probability of suffering from allergic asthma. In this sense, it has been suggested that non-allergic asthma may have a lesser response to treatment with inhaled corticoids and, therefore, could be more difficult to treat.31 In the case of COPD, it has also been demonstrated that women have greater psychological distress rates, as well as less perceived control over symptoms and a greater degree of functional worsening than men.32
The coordination of the ECRHS II was supported by the European Commission as part of their Quality of Life program.
Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.