Asthma remission in North America: from childhood to adulthood
Monday, March 5, 2018
South Hall A2 (Convention Center)
Alberta L. Wang, MD, Soma Datta, Scott T. Weiss, MD MS, Kelan Tantisira, MD MPH
RATIONALE: Few data exist on the longitudinal history of childhood asthma and predictors of asthma remission in adulthood in North America. This study aimed to define the prevalence and predictors of asthma remission from childhood to adulthood in an ethnically diverse population of mild-to-moderate persistent asthmatics.

METHODS: Adult asthma remission was measured using two remission definitions, a loose and a strict definition. Both included normal percent predicted lung function and the absence of symptoms, exacerbations, and medication use. The strict definition also included normal airway responsiveness. Predictors of remission were identified from 23 baseline measures using multinomial logistic regression.

RESULTS: Of 879 participants, mean baseline age was 8.8 years (SD ± 2.1), 59.4% were males, and 68.7% were Caucasian. In adulthood, 229 (26.0%) of 879 participants were in loose remission and 111 (15.0%) of 741 participants were in strict remission. Both definitions were associated with decreased baseline airway obstruction (loose remission OR 4.62, 95% CI 3.35-6.50; strict remission OR 5.71, 95% CI 3.58-9.45) and airway hyperresponsiveness (loose remission OR 1.23, 95% CI 1.09-1.39; strict remission OR 1.52, 95% CI 1.26-1.84). Females with less airway obstruction had higher odds of loose remission than males (females OR 8.03, 95% CI 4.60-14.93; males OR 3.88, 95% CI 2.62-5.92). Strict remission was inversely associated with serum IgE level (OR 0.88, 95% CI 0.78-1.00) and positive aeroallergen skin testing (OR 0.48, 95% CI 0.24-0.97).

CONCLUSIONS: A large minority of persistent childhood asthmatics will undergo disease remission. Predictors of asthma remission at adulthood can be seen from an early age.