PT  - JOURNAL ARTICLE
AU  - Hanneke Coumou
AU  - Guus A. Westerhof
AU  - Selma B. de Nijs
AU  - Aeilko H. Zwinderman
AU  - Elisabeth H. Bel
TI  - Predictors of accelerated decline in lung function in adult-onset asthma
AID  - 10.1183/13993003.01785-2017
DP  - 2018 Feb 01
TA  - European Respiratory Journal
PG  - 1701785
VI  - 51
IP  - 2
4099  - http://erj.ersjournals.com/content/51/2/1701785.short
4100  - http://erj.ersjournals.com/content/51/2/1701785.full
SO  - Eur Respir J2018 Feb 01; 51
AB  - Little is known about the prognosis of adults with new-onset asthma. Cross-sectional studies suggest that these patients may exhibit accelerated decline in forced expiratory volume in 1 s (FEV1). However, risk factors for accelerated decline in lung function have not yet been identified.We aimed to identify these risk factors in a prospective 5-year follow-up study in 200 adults with newly diagnosed asthma. In the current study, clinical, functional and inflammatory parameters were assessed annually for 5 years. Linear mixed-effects models were used to identify predictors.Evaluable lung function sets of 141 patients were available. Median (interquartile range) change in post-bronchodilator FEV1 was −17.5 (−54.2 to +22.4) mL per year. Accelerated decline in FEV1 was defined by the lower quartile of decline (>54.2 mL per year). Nasal polyps, number of blood and sputum eosinophils, body mass index, and level of exhaled nitric oxide were univariably associated with decline in lung function. Only the latter two were independently associated. Using cut-off values to identify patients at highest risk showed accelerated decline in FEV1 in all patients with combined exhaled nitric oxide fraction (FeNO) ≥57 ppb and body mass index (BMI) ≤23 kg·m−2.We conclude that adults with new-onset asthma with both high levels of exhaled nitric oxide and low BMI are at risk of accelerated decline in lung function.Exhaled nitric oxide and BMI predict accelerated decline in FEV1 in adults with new-onset asthma http://ow.ly/1yDz30hE5YE