Asthma severity is variable and unpredictable

SAN DIEGO (November 6, 2002) -- When asthma patients are classified as having mild, moderate or severe persistent asthma, they should not assume that the severity of their asthma will remain stable over time.

Instead, asthma severity can fluctuate markedly over time, according to a study presented today at CHEST 2002, the annual meeting of the American College of Chest Physicians. Patients not taking controller medications can frequently move between severity categories -- a patient classified with a particular severity of asthma one week may exhibit symptoms or lung function findings consistent with another severity classification the next. As a result, discrete measurements of lung function, albuterol use or asthma symptoms taken on any given day may not provide an accurate picture of overall asthma severity and stability.

The study has important implications for how asthma patients are managed and the measurements physicians use to assess asthma severity. This study may also provide new insight into why both patients and physicians tend to underestimate the severity of asthma.1

The study, a retrospective analysis of two previously conducted 12-week clinical trials that included patients who had used only beta2-agonists (such as albuterol or salmeterol) for their asthma and were subsequently randomized to receive placebo and as-needed albuterol. GlaxoSmithKline researchers identified 85 such patients in these trials. The daily diary data from these patients -- which included asthma symptoms, albuterol use and peak expiratory flow (a measure of lung function) -- were reviewed to determine asthma severity based on criteria established by the National Institutes of Health.

The key finding: patients had marked fluctuations in the severity of their asthma. At study baseline, all patients met the criteria for moderate-to-severe asthma, having a mean baseline FEV1 (a measure of lung function) of 64 percent predicted and asthma symptoms and


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