Remission of persistent childhood asthma: Early predictors of adult outcomes.

Adult Asthma / diagnosis Child Eosinophils / pathology Ethnicity Female Humans Leukocyte Count Male Predictive Value of Tests Prognosis Respiratory Function Tests Respiratory Hypersensitivity / diagnosis Treatment Outcome United States / epidemiology
Pediatric asthma asthma remission prognostication

Journal

The Journal of allergy and clinical immunology
ISSN: 1097-6825
Titre abrégé: J Allergy Clin Immunol
Pays: United States
ID NLM: 1275002

Informations de publication

Date de publication:
05 2019
Historique:
received: 04 06 2018
revised: 20 08 2018
accepted: 21 09 2018
pubmed: 18 11 2018
medline: 12 5 2020
entrez: 17 11 2018
Statut: ppublish

Résumé

Few data exist on the predictors of asthma remission by early adulthood in North America. The predictors of adult asthma remission were determined in a multiethnic population of patients with mild-to-moderate persistent childhood asthma. Asthma remission in early adulthood was measured by using 2 definitions: a clinical and a strict definition. Both included normal lung function and the absence of symptoms, exacerbations, and medication use. The strict definition also included normal airways responsiveness. Predictors were identified from 23 baseline measures by using multivariate logistic regression. The probability of remission was modeled by using decision tree analysis. In 879 subjects the mean ± SD baseline age was 8.8 ± 2.1 years, 59.4% were male, and 68.7% were white. By adulthood, 229 (26.0%) of 879 participants were in clinical remission, and 111 (15.0%) of 741 participants were in strict remission. The degree of FEV A considerable minority of patients with persistent childhood asthma will have disease remission by adulthood. Clinical prognostic indicators of asthma remission, including baseline lung function, can be seen from an early age.

Sections du résumé

BACKGROUND
Few data exist on the predictors of asthma remission by early adulthood in North America.
OBJECTIVE
The predictors of adult asthma remission were determined in a multiethnic population of patients with mild-to-moderate persistent childhood asthma.
METHODS
Asthma remission in early adulthood was measured by using 2 definitions: a clinical and a strict definition. Both included normal lung function and the absence of symptoms, exacerbations, and medication use. The strict definition also included normal airways responsiveness. Predictors were identified from 23 baseline measures by using multivariate logistic regression. The probability of remission was modeled by using decision tree analysis.
RESULTS
In 879 subjects the mean ± SD baseline age was 8.8 ± 2.1 years, 59.4% were male, and 68.7% were white. By adulthood, 229 (26.0%) of 879 participants were in clinical remission, and 111 (15.0%) of 741 participants were in strict remission. The degree of FEV
CONCLUSION
A considerable minority of patients with persistent childhood asthma will have disease remission by adulthood. Clinical prognostic indicators of asthma remission, including baseline lung function, can be seen from an early age.

Identifiants

DOI: 10.1016/j.jaci.2018.09.038 PMID: 30445065 PMC: PMC7061344
pubmed: 30445065
pii: S0091-6749(18)31590-2
doi: 10.1016/j.jaci.2018.09.038
pmc: PMC7061344
mid: NIHMS1564699
pii:
doi:

Types de publication

Comparative Study Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1752-1759.e6

Subventions

Organisme : NHLBI NIH HHS
ID : R01 HL129935
Pays : United States
Organisme : NCRR NIH HHS
ID : UL1 RR025780
Pays : United States
Organisme : NIAID NIH HHS
ID : T32 AI007306
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL065899
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL075417
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL075416
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL075419
Pays : United States
Organisme : NCRR NIH HHS
ID : M01 RR000051
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL075408
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL075232
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL075415
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL075407
Pays : United States
Organisme : NCRR NIH HHS
ID : M01 RR002719
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL075420
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR000154
Pays : United States
Organisme : NCRR NIH HHS
ID : M01 RR000036
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL075409
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01HR16044
Pays : United States
Organisme : NHLBI NIH HHS
ID : T32 HL007427
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL127332
Pays : United States

Commentaires et corrections

Type : CommentIn
Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2018. Published by Elsevier Inc.

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Auteurs

Alberta L Wang (AL)

Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.

Soma Datta (S)

Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.

Scott T Weiss (ST)

Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.

Kelan G Tantisira (KG)

Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass; Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass. Electronic address: rekgt@channing.harvard.edu.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Remission of persistent childhood asthma:...
questionsmedicales.fr › Maladies du système immunitaire › Hypersensibilité › Hypersensibilité immédiate › Hypersensibilité respiratoire › Asthme › Remission of persistent childhood asthma:...
questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Remission of persistent childhood asthma:...
questionsmedicales.fr › Systèmes sanguin et immunitaire › Système immunitaire › Leucocytes › Granulocytes › Granulocytes éosinophiles › Remission of persistent childhood asthma:...
questionsmedicales.fr › Caractéristiques de la population › Ethnies › Remission of persistent childhood asthma:...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Remission of persistent childhood asthma:...
questionsmedicales.fr › Phénomènes physiologiques respiratoires et circulatoires › Phénomènes physiogiques du sang › Hémogramme › Numération des leucocytes › Remission of persistent childhood asthma:...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Méthodologie en recherche épidémiologique › Valeur prédictive des tests › Remission of persistent childhood asthma:...
questionsmedicales.fr › Diagnostic › Pronostic › Remission of persistent childhood asthma:...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Techniques de diagnostic respiratoire › Tests de la fonction respiratoire › Remission of persistent childhood asthma:...
questionsmedicales.fr › Maladies du système immunitaire › Hypersensibilité › Hypersensibilité immédiate › Hypersensibilité respiratoire › Remission of persistent childhood asthma:...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Remission of persistent childhood asthma:...
questionsmedicales.fr › Régions géographiques › Amériques › Amérique du Nord › États-Unis › Remission of persistent childhood asthma:...