RT Journal Article
SR Electronic
T1 Remission of adult onset asthma is rare – a 15 year follow-up study
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00620-2020
DO 10.1183/23120541.00620-2020
A1 Linnéa Almqvist
A1 Eva Rönmark
A1 Caroline Stridsman
A1 Helena Backman
A1 Anne Lindberg
A1 Bo Lundbäck
A1 Linnéa Hedman
YR 2020
UL http://openres.ersjournals.com/content/early/2020/09/17/23120541.00620-2020.abstract
AB Background There are few long-term clinical follow-up studies of adult onset asthma.Aim 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 in 1995–99 from the general population in northern Sweden. The cohort was followed-up in 2003 (n=250) and 2012–14 (n=205). Structured interviews and spirometry were performed at recruitment and the follow-ups. Bronchial hyper-reactivity (BHR) and skin prick tests were performed at recruitment, and blood samples 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 until 2012–14, and in total, n=23 (11%) were in remission while n=182 had persistent asthma in 2012–14. Those in remission had higher mean FEV1 percent of predicted (pp) 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 BMI 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 or controlled asthma.Conclusion Higher FEV1 pp 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.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Almqvist has nothing to disclose.Conflict of interest: Dr. Rönmark has nothing to disclose.Conflict of interest: Dr. 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: Dr. Hedman has nothing to disclose.