Childhood Asthma Linked to COPD Risk

Children with severe asthma have a greater risk for developing chronic obstructive pulmonary disease, new data suggest.

“It is increasingly apparent that [chronic obstructive pulmonary disease] often has its roots decades before the onset of symptoms. Impaired growth of lung function during childhood and adolescence, caused by premature gestation, asthma, recurrent infections or tobacco smoking, may lead to lower maximally attained lung function in early adulthood and also predispose to development of COPD,” Andrew Tai, PhD, of the department of respiratory and sleep medicine, at the Women’s and Children’s Hospital in Australia, and colleagues wrote.

The Melbourne Asthma Cohort included children from a 1957 birth cohort with asthma aged 6 to 7 years, who participated in respiratory questionnaires and lung function spirometry with post-bronchodilator response every 7 years until age 50.

Of the 484 originally included in the study, 21 died and 346 were included in the study (76% participation rate); 197 completed both questionnaire and lung function tests, according to data.

Children with severe asthma demonstrated an adjusted 32 times higher risk for developing COPD (95% CI, 3.4-269) compared with children without symptoms of wheeze to the age of 7, according to data. Moreover, 43% of patients in the COPD group never smoked, researchers wrote.

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The researchers found no differences in the rate of declining FEV1 per year between those in the COPD group (17%; 95% CI, 10-23) and the other groups, including: non-asthmatics (16%; 95% CI, 12-21), asthma remission (20%; 95% CI, 16-24) and current asthma (19%; 95% CI, 13-25), according to data.

“The fixed abnormalities in lung function in adult life are clearly established in childhood and track at lower values progressing to irreversible airway obstruction in adulthood,” they wrote.

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