|Asthma was ruled out in a third of adults who were re-evaluated several years after first being diagnosed with the condition. The findings appear in JAMA.
Over 600 randomly selected adults who’d received a physician diagnosis of asthma within the previous 5 years completed symptom questionnaires and underwent spirometry (patients on long-term oral steroids or unable to tolerate spirometry were excluded). If asthma wasn’t confirmed during spirometry, patients underwent serial bronchial challenge tests. If appropriate, patients were gradually tapered off all asthma medications over 6 weeks.
Roughly 200 patients were determined not to have current asthma. These patients were less likely to have received diagnostic testing for airflow limitation at their initial diagnosis, compared to those with confirmed asthma.
Editorialists see two clinical takeaways: “First, patients who have been diagnosed with adult-onset asthma may not continue to have asthma or to require asthma treatment indefinitely. Second, physiological testing, such as spirometry before and after bronchodilator administration, is an essential component of the diagnosis of asthma to avoid unnecessary treatment or an incorrect diagnosis.”