Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Unit of Clinical Physiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.
J Allergy Clin Immunol Pract. 2021 May;9(5):1950-1959.e4. doi: 10.1016/j.jaip.2020.12.015. Epub 2020 Dec 15.
Child-onset asthma is known to remit with high probability, but remission in adult-onset asthma is seemingly less frequent. Reports of the association between remission and asthma age of onset up to late adulthood are scarce.
To evaluate the association between asthma remission, age at diagnosis and gender, and assess risk factors of nonremission.
In 2016, a random sample of 16,000 subjects aged 20 to 69 years from Helsinki and Western Finland were sent a FinEsS questionnaire. Physician-diagnosed asthma was categorized by age at diagnosis to early- (0-11 years), intermediate- (12-39 years), and late-diagnosed (40-69 years) asthma. Asthma remission was defined by not having had asthma symptoms and not having used asthma medication in the past 12 months.
Totally, 8199 (51.5%) responded, and 879 reported physician-diagnosed asthma. Remission was most common in early-diagnosed (30.2%), followed by intermediate-diagnosed (17.9%), and least common in late-diagnosed asthma (5.0%) (P < .001), and the median times from diagnosis were 27, 18.5, and 10 years, respectively. In males, the corresponding remission rates were 36.7%, 20.0%, and 3.4%, and in females, 20.4%, 16.6%, and 5.9% (gender difference P < .001). In multivariable binary logistic regression analysis, significant risk factors of asthma nonremission were intermediate (odds ratio [OR] = 2.15, 95% confidence interval: 1.37-3.36) and late diagnosis (OR = 11.06, 4.82-25.37) compared with early diagnosis, chronic obstructive pulmonary disease (COPD) (OR = 5.56, 1.26-24.49), allergic rhinitis (OR = 2.28, 1.50-3.46), and family history of asthma (OR = 1.86, 1.22-2.85). Results were similar after excluding COPD.
Remission was rare in adults diagnosed with asthma after age 40 years in both genders. Late-diagnosed asthma was the most significant independent risk factor for nonremission.
儿童期起病的哮喘有很大的概率可以缓解，但成人期起病的哮喘的缓解似乎不太常见。关于缓解与哮喘发病年龄直至成年后期之间的关联的报告很少。
评估哮喘缓解、诊断年龄和性别之间的关联，并评估非缓解的危险因素。
2016 年，对来自赫尔辛基和芬兰西部的 20 至 69 岁的 16000 名随机样本发送了一份 FinEsS 调查问卷。通过诊断年龄将医生诊断的哮喘分为早发（0-11 岁）、中发（12-39 岁）和晚发（40-69 岁）哮喘。哮喘缓解定义为过去 12 个月内没有哮喘症状且未使用哮喘药物。
共有 8199 人（51.5%）做出了回应，其中 879 人报告了医生诊断的哮喘。早发哮喘（30.2%）的缓解最为常见，其次是中发哮喘（17.9%），晚发哮喘（5.0%）缓解最少（P<0.001），相应的诊断后中位时间分别为 27、18.5 和 10 年。男性的缓解率分别为 36.7%、20.0%和 3.4%，女性的缓解率分别为 20.4%、16.6%和 5.9%（性别差异 P<0.001）。在多变量二元逻辑回归分析中，与早发诊断相比，中发（比值比[OR]2.15，95%置信区间：1.37-3.36）和晚发（OR 11.06，4.82-25.37）诊断、慢性阻塞性肺疾病（COPD）（OR 5.56，1.26-24.49）、过敏性鼻炎（OR 2.28，1.50-3.46）和哮喘家族史（OR 1.86，1.22-2.85）是哮喘非缓解的显著危险因素。排除 COPD 后结果相似。
在男性和女性中，40 岁以后被诊断为哮喘的患者很少缓解。晚发哮喘是最重要的非缓解独立危险因素。
