Delayed Treatment with Inhaled Corticosteroids Affects Lung Function in Asthma, finds study
Researchers have found in a new study that patients with severe asthma beginning inhaled corticosteroid therapy (ICS) after decades delay exhibit different lung function trajectories. ICS is still considered the first-line treatment for asthma, but its long-standing effects on the lung function decline remain uncertain, especially after delayed initiation. This research was an examination of lung function decline, bearing in mind the predictors of FEV1 modifications and exacerbations in patients with previously untreated severe asthma. The study was conducted by Pca Almeida and colleagues which was published in the Journal of Asthma.
A ten-year-long observational study of 184 patients with asthma following regular inhaled corticosteroid (ICS) treatment was conducted. Most patients were female (84%) and over 50 years old. After a median of 30 years on regular ICS, they began. The lung function decline was assessed using two baseline options: (i) FEV1 after one year of regular treatment (V1) and (ii) the best FEV1 of any recorded previously before the final visit. This study aims to compare lung function outlines during the overall follow-up time with respect to the baseline and teeter and recognize predictors of further FEV1 decline and exacerbations.
Key Results
FEV1 Decline: More than half of the subjects (54%) demonstrated an FEV1 decline of more than 25 ml/year on post-treatment lung function (V1).
Predictors of Decline: Those with faster FEV1 decline were younger, had shorter asthma duration, and had better lung function at V1.
Obstruction and Decline: Participants who did not manifest an obstructive pattern (74%) or mild obstruction (64%) at V1 showed more pronounced absolute FEV1 decline. However, those with preserved ratio-impaired spirometry (PRISm) were more appreciably impacted relative decline-wise.
Exacerbations: Exacerbations within the first year of ICS treatment were strong predictors of future exacerbations and absolute lung function decline.
Treatment Delay Impact: The longer period without ICS treatment was associated with relative FEV1 reduction and thus emphasizes the importance of early intervention.
The study authors concluded that long-time delay in ICS treatment results in marked decline in lung function of the patient of asthma. This underlines the vital need for early and continued use of ICS, thus preserving lung function as well as inhibiting exacerbation. Patients with treatment delays in history should further undergo regular monitoring for optimal disease management to help reduce long-term respiratory complications.
Reference:
Almeida P, Ponte E, Stelmach R, Harrison T, Scichilone N, Souza-Machado A, Cruz A. Exacerbation during the first year of treatment affects lung function in subjects with asthma - a 10-year follow-up. J Asthma. 2025 Feb 7:1-10. doi: 10.1080/02770903.2025.2451690. Epub ahead of print. PMID: 39888725.
