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. 2020 Nov 23;6(4):00620-2020.
doi: 10.1183/23120541.00620-2020. eCollection 2020 Oct.

Remission of adult-onset asthma is rare: a 15-year follow-up study

Linnéa Almqvist  1 , Eva Rönmark  1 , Caroline Stridsman  2 , Helena Backman  1   3 , Anne Lindberg  2 , Bo Lundbäck  4 , Linnéa Hedman  1   3
Affiliations

Remission of adult-onset asthma is rare: a 15-year follow-up study

Linnéa Almqvist et al. ERJ Open Res. .

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.

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Conflict of interest statement

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.

Figures

FIGURE 1
FIGURE 1
Flow chart of the study population.
FIGURE 2
FIGURE 2
Remission and relapse of adult-onset asthma, from recruitment between 1995 and 1999 until follow-up between 2012 and 2014.
FIGURE 3
FIGURE 3
Remission of adult-onset asthma at follow-up between 2012 and 2014 in relation to forced expiratory volume in 1 s (FEV1) % predicted and severe bronchial hyperreactivity (BHR; PC20 ≤1 mg·mL−1) at recruitment between 1995 and 1999. Logistic regression analyses, presented as unadjusted and adjusted for sex, age, family history of asthma, body mass index and smoking habits at recruitment. PC20: provocative concentration causing a 20% fall in FEV1.
See this image and copyright information in PMC

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