Page 24 - ADULT-ONSET ASTHMA PREDICTORS OF CLINICAL COURSE AND SEVERITY

ADULT-ONSET ASTHMA – PREDICTORS OF CLINICAL COURSE AND SEVERITY
ABSTRACT
This narra ve review examines the known prognos c factors of adult-onset asthma with respect to lung func on decline, increased asthma severity and asthma remission. The number of longitudinal studies inves ga ng the course of adult-onset asthma is limited, which highlights the need for further follow-up studies. Ampli ed lung func on decline is associated with male gender, atopic status and poor baseline lung func on. Increased asthma severity is in uenced by smoking and low lung func on, whereas current uncontrolled asthma and smoking predict having uncontrolled asthma in the future. Asthma exacerba ons can be predicted by high symptom scores, low lung func on and markers of airway eosinophilia. Remission rate of adult-onset asthma is low and mainly seen in pa ents with mild asthma and a short disease dura on. Smoking has a profound nega ve e ect on asthma remission. The most important factor for prognosis of occupa onal asthma is ceasing exposure to the causa ve agent, which has a posi ve e ect on all aspects of the disease.
Conclusion: Two prominent in uen al factors in all domains of adult-onset asthma prognosis are smoking and baseline lung func on. Clinicians trea ng adult-onset asthma pa ents should no ce these factors and realize these pa ents are at risk for a poor prognosis. However, more research is needed in order to o er pa ents more certainty about their prognosis and possible treatable factors.
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