Worsening Lung Function in Young Asthmatics

A large-scale study has found that about a quarter of children with mild-to-moderate asthma suffered a significant loss of lung function over a period of four to six years, particularly younger, male children. The results were reported in the August 2004 issue of the American Journal of Respiratory and Critical Care Medicine.

Researchers evaluated the lung function of 990 children with mild-to-moderate asthma for four to six years. All were taking a rescue medication, albuterol, and were divided evenly among those also taking a placebo, the steroid budesonide, or nedocromil. Lung function was measured primarily by the amount of air the children could exhale in one second, called forced expiratory volume (FEV1). As a whole, the group experienced a minimal decline in lung function of 0.2% per year of predicted FEV1. However, 253 of the children lost more than 1% per year of predicted FEV1, five times the average lung function decline of the group as a whole.

Medications did not appear to alter the course of the disease. Loss of lung function occurred equally among children taking either one of the anti-inflammatory medications or placebo. Also, lung-function loss occurred equally among children with mild and with moderate asthma. A distinguishing feature, however, was that almost 70% of these subjects were male and were younger (7.56 years vs 8.74 years). Also, the decliners had suffered asthma for a shorter period of time. On average, they had greater lung function when they entered the study but worse lung function by the end of the study.

"We believe it is important to monitor lung function in children with asthma over the course of several years in order to detect those patients with the declining trend,” said co-author Ronina Covar, M.D., assistant professor of pediatrics at U.S. National Jewish Medical and Research Center (Denver, CO, USA).




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