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Asthma variability in patients previously treated with beta2-agonists alone.
William J Calhoun1, Laura B Sutton, Amanda Emmett
1Division of Pulmonary Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA.
The Journal of Allergy and Clinical Immunology
|December 6, 2003
Summary
Asthma severity fluctuates significantly over time, even in patients not on maintenance treatment. Current assessments may underestimate disease severity, potentially leading to inadequate asthma management and increased morbidity.
Area of Science:
- Pulmonary Medicine
- Clinical Trials
- Asthma Research
Background:
- National asthma guidelines classify severity (intermittent, mild, moderate, severe) based on lung function, symptoms, and exacerbations.
- Patient asthma severity is often assumed to be consistent over time, but empirical evidence is limited.
Purpose of the Study:
- To evaluate the variability of asthma severity and control in patients with persistent asthma.
- To assess patients who have not yet initiated asthma maintenance therapy.
Main Methods:
- Analysis of placebo-treated patients (n=85) from two 12-week randomized clinical trials.
- Assessment of asthma severity control using lung function (peak expiratory flow), short-acting beta-agonist use (albuterol), and symptom frequency.
Main Results:
- At baseline, all patients had moderate to severe persistent asthma.
- Patients spent 71% of weeks in the moderate asthma category, but lung function varied daily, with 52% of days classified as intermittent-mild.
- Short-acting beta-agonist use and symptoms indicated intermittent or mild asthma for 59% and 45% of weeks, respectively.
Conclusions:
- Point-in-time assessments of lung function, medication use, or symptoms are insufficient for accurate asthma control evaluation.
- Inconsistent disease control may lead to underestimation of asthma severity.
- Inadequate assessment can result in suboptimal treatment and increased asthma-related illness (morbidity).
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