Abstract
Background There are few long-term clinical follow-up studies of adult-onset asthma. The aim of this article was to study clinical characteristics of adult-onset asthma in relation to remission and persistence of the disease in a 15-year follow-up.
Methods A cohort of 309 adults aged 20–60 years with asthma onset during the last 12 months verified by bronchial variability, was recruited between 1995 and 1999 from the general population in northern Sweden. The cohort was followed-up in 2003 (n=250) and between 2012 and 2014 (n=205). Structured interviews and spirometry were performed at recruitment and the follow-ups. Bronchial hyperreactivity (BHR) and skin-prick tests were performed at recruitment and blood samples were collected at the last follow-up. Remission of asthma was defined as no asthma symptoms and no use of asthma medication during the last 12 months.
Results Of eight individuals in remission in 2003, five had relapsed between 2012 and 2014 and in total, 23 (11%) were in remission, while 182 had persistent asthma. Those in remission had higher mean forced expiratory volume in 1 s % predicted at recruitment than those with persistent asthma (94.6 versus 88.3, p=0.034), fewer had severe BHR (27.3% versus 50.9%, p=0.037) and they had less body mass index increase (+1.6 versus +3.0, p=0.054). Of those with persistent asthma, 13% had uncontrolled asthma and they had higher levels of blood neutrophils than those with partly controlled or controlled asthma.
Conclusion Higher forced expiratory volume in 1 s % predicted and less-severe BHR was associated with remission of adult-onset asthma, but still, the proportion in remission in this 15-year follow-up was low.
Abstract
In this 15-year follow-up of a cohort with adult-onset asthma, the remission rate was low, and predictors of remission were higher FEV1 % predicted and less-severe bronchial hyperreactivity at asthma onset https://bit.ly/2FEgoFa
Footnotes
Conflict of interest: L. Almqvist has nothing to disclose.
Conflict of interest: E. Rönmark has nothing to disclose.
Conflict of interest: C. Stridsman has nothing to disclose.
Conflict of interest: H. Backman reports speaking fees from Boehringer Ingelheim and AstraZeneca outside the submitted work.
Conflict of interest: A. Lindberg reports personal fees for lectures and an advisory board from Boehringer Ingelheim, personal fees for an advisory board from AstraZeneca, personal fees for lectures from Novartis, and personal fees for an advisory board from GlaxoSmithKline, outside the submitted work.
Conflict of interest: B. Lundbäck reports personal fees for participating at advisory board meetings from GSK and Sanofi, outside the submitted work.
Conflict of interest: L. Hedman has nothing to disclose.
Support statement: Financial support was received from the Swedish Heart Lung Foundation (ALF), a regional agreement between Umeå University and Västerbotten County Council, the Swedish Council for Working Life (RALF), Center for Environmental Research, Umeå (CMF), the Swedish Asthma-Allergy Foundation, the Swedish Foundation for Health Care Science and Allergy Research (Vårdal), Norrbotten County Council and Visare Norr. Additional support was provided by GlaxoSmithKline and Thermo Fisher Scientific. Funding information for this article has been deposited with the Crossref Funder Registry.
- Received August 28, 2020.
- Accepted September 12, 2020.
- Copyright ©ERS 2020
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