Page 102 - ADULT-ONSET ASTHMA PREDICTORS OF CLINICAL COURSE AND SEVERITY

ADULT-ONSET ASTHMA – PREDICTORS OF CLINICAL COURSE AND SEVERITY
ABSTRACT
BACKGROUND: Adult-onset asthma is an important but rela vely understudied asthma phenotype and li le is known about its natural course and prognosis. The remission rate is believed to be low, and it is s ll obscure which factors predict remission or persistence of the disease.
OBJECTIVE: To determine the remission rate, and iden fy predictors of persistence and remission of adult-onset asthma.
METHODS: Two hundred adult pa ents with recently diagnosed (<1 year) asthma were recruited from secondary and ter ary pulmonary clinics and prospec vely followed for 5 years. Clinical, func onal and in ammatory parameters were assessed at baseline and at yearly visits. Asthma remission was de ned as absence of asthma symptoms for ≥1 year and no asthma medica on use for ≥1 year. Descrip ve sta s cs and logis c regression analysis were performed.
RESULTS: Five-year follow-up data of 170 pa ents (85%) was available. Of these, 27 pa ents (15.9%) experienced asthma remission. Pa ents with asthma persistence were older, had worse asthma control, required higher doses of inhaled cor costeroids, had more severe airway hyperresponsiveness, more o en nasal polyps and higher levels of blood neutrophils as compared to pa ents who experienced clinical remission.
In a multivariable logistic regression analysis, only moderate-severe bronchial hyperresponsiveness and nasal polyps were independent predictors of asthma persistence. Pa ents with these two characteris cs had less than 1% chance of asthma remission.
CONCLUSION: One in six pa ents with adult-onset asthma experiences remission within the rst 5 years of the disease. In pa ents with moderate to severe bronchial hyperresponsiveness and nasal polyposis the chance of remission is close to zero.
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