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  • Title: [The course of bronchial asthma in adults. Factors of importance for the annual decline of lung function].
    Author: Ulrik CS, Backer V, Dirksen A.
    Journal: Ugeskr Laeger; 1993 Mar 22; 155(12):867-71. PubMed ID: 8480383.
    Abstract:
    The purpose of this study was to describe the relation of various factors of potential importance to the rate of decline in lung function in adults with intrinsic and extrinsic asthma. Of 180 asthmatic patients, 143 (79%) participated in a 10 year follow up examination; 94 patients had intrinsic asthma and 49 extrinsic asthma. Patients with intrinsic asthma had an annual decline in FEV1 of 50 ml, whereas those with extrinsic asthma had a decline of 23 ml; the rate of decline of lung function increased with increasing age in both groups. There was no relation between rate of decline in lung function and number of cigarettes smoked. An inverse relation between initial FEV1 and decline in FEV1 was found for the patients with extrinsic asthma but not for the patients with intrinsic asthma. A high degree of airway variability--that is, reversibility in FEV1--at the time of enrollment was found to be associated with a steeper decline in lung function in patients with intrinsic asthma, whereas increasing degrees of obstruction (decreasing FEV1/VC ratio at enrollment) and need for treatment with corticosteroids were associated with a more pronounced decline in FEV1 in patients with extrinsic asthma. The rate of decline in lung function is greater in patients with intrinsic asthma than in patients with extrinsic asthma; the prognosis for intrinsic and extrinsic asthma is to some extent influenced by different factors, which suggests that the pathogenetic mechanisms underlying intrinsic and extrinsic asthma may differ.
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