Page 103 - ADULT-ONSET ASTHMA PREDICTORS OF CLINICAL COURSE AND SEVERITY

CLINICAL PREDICTORS OF REMISSION AND PERSISTENCE OF ADULT-ONSET ASTHMA
INTRODUCTION
Adult-onset asthma is a clinically important, but rela vely understudied phenotype of asthma.1 In contrast to childhood atopic asthma, adult-onset asthma had not been inves gated systema cally un l 2004.2 Most available data about adult-onset asthma come from cross- sec onal studies and have shown that it is a heterogeneous condi on with at least three dis nct phenotypes.3 Adult-onset asthma is suggested to be more severe than childhood onset asthma, less responsive to treatment and associated with accelerated decline in lung func on.4 Remission of childhood-onset asthma occurs in up to two-thirds of the pa ents,5-7 whereas adult-onset asthma has been reported to be more chronic with a much lower remission rate.6, 8-13 However, most of these studies are di cult to interpret because they are based on “self- reported asthma” or “self-reported physician-diagnosed asthma” or database data in which a mixed childhood- and adult-onset popula on is studied. Only two studies prospec vely followed pa ents with adult-onset asthma, but unfortunately these studies lacked power to test predictors of remission by mul variable analysis.9, 13
Knowledge about the clinical course and outcome of adult-onset asthma and its determinants may be important for several reasons. For pa ents, it is important to know the chance of disease remission or persistence so that they can adjust plans for their future life. For physicians, knowing risk factors of asthma persistence might serve to iden fy treatable factors with a poten al bene cial e ect on the course of the disease.14 For researchers, iden ca on of determinants of asthma outcome might help to be er understand the ae ology of the disease. Finally, for policy makers and health care payers, knowledge of asthma remission and persistence rates will allow more accurate es mates of healthcare expenditure.
The aim of the present study was to iden fy clinical, func onal or in ammatory predictors of asthma persistence and remission in a prospec vely followed cohort of adults with newly diagnosed, well-de ned asthma.
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