LUNG FUNCTION DECLINE IN ASTHMA

Although it is recognised that asthmatic subjects have an accelerated decline in lung function, factors affecting the long term outcome of asthma are still relatively unknown. In this issue of Thorax we report two studies and publish an editorial on this topic. Lange and colleagues describe the 10 year follow up of two groups of asthmatic subjects, one of which was treated with inhaled corticosteroids (ICS). After adjustment for other variables, treatment with ICS was associated with a significant reduction in the decline in forced expiratory volume in 1 second (FEV₁), with a decline of 51 ml/year in patients not receiving treatment with ICS and 25 ml/year in the ICS group. In his editorial Ernst discusses the implications and limitations of this study and suggests that, although the effects of ICS on disease progression were evident in the group as a whole, the benefit may vary substantially between asthmatic individuals. …