When onset of asthma was diagnosed in childhood, approximately 62% still had asthma at 28 years of age, according to results of a study published in Respiratory Medicine. In the study, investigators aimed to determine the factors associated with persistent asthma and how likely remission of childhood asthma is.
The cohort was recruited in 1996, including children in first and second grade aged from 7 to 8 years. Parents of the children answered a questionnaire about asthma, rhinitis, and eczema, according to the study authors. There were 248 children who had asthma at the time of eligibility and investigators provided annual follow-up questionnaires until age 19. Following up was conducted again when participants were 28 years of age.
The same questionnaire was used for all annual surveys, with questions about diagnosis, use of medication, and risk factors, which could include parental smoking, family history of allergies, environmental exposures, and more, according to the study authors. The questionnaire at age 28 years included questions regarding physician diagnosis of asthma, respiratory symptoms, and use of asthma medication within the last 12 months.
Of the eligible 248 individuals, 6 individuals migrated from Sweden (where the study was conducted), 8 individuals could not be traced, and 64 individuals declined participation by age 28 years. Of the 234 individuals invited for follow up, 73% (N=170) participated at age 28 years, 44.7% of whom were women. Among the 170 individuals, 61.8% still had asthma, with only 65 in remission. Of 32 individuals in remission at age 19 years, 73% were men and only 75% had lasting remission until 28 years. Additionally, of 68 individuals with persistent asthma at 19 years, 14.7% were in remission, according to the study authors.
The study authors also reported that severe respiratory infection in childhood was more frequent among those with current asthma at 28 years, at 82.8% compared to those without at 69.2%. Further, breastfeeding less than 9 months was more common for those in remission at 50% compared to those with asthma at 29.7%. Investigators also found that eczema, rhinoconjunctivitis, or allergic sensitization at 8 years old was more common for those with current asthma compared to those in remission as well as a higher mean severity score, according to the authors.
Key Takeaways
- A significant proportion of children diagnosed with asthma early in life continue to have asthma as adults. The study found that over 60% (61.8%) of participants diagnosed with asthma at age 7-8 still had asthma at age 28.
- The study highlights a lower remission rate than previously reported, with only about a third (38.2%) of participants achieving remission by age 28.
- The study found no significant differences in lung function, body mass index, or smoking habits between those with persistent asthma and those who achieved remission.
However, investigators reported there were no clinical differences at 19 years for lung function, body mass index, daily smoking, exposure to parental tobacco smoke, or house dampness for those in remission and those with asthma at age 28 years. Bronchial hyperactivity at 17 years old was more common among those with current asthma at 28 years at 76.9% than those without at 33.3%, according to the study authors. They also found this to be the case for rhinoconjunctivitis and allergic sensitization at 19 years old.
For both men and women, investigators found that there were similarities between those who had current asthma at 64.5% and 59.4%, respectively. For those with allergic sensitization at 19 years, current asthma was associated with breastfeeding more than 3 months, severe respiratory infection, rhinoconjunctivitis, and higher severity score at 8 years old, according to the study authors. For those without allergic sensitization at 19, current asthma at 28 years was associated with a lower birthweight, the results showed.
Reference
Almqvist L, Andersson M, Backman H, Rönmark E, Hedman L. No remission in 60% of those with childhood-onset asthma - A population-based cohort followed from 8 to 28 years of age. Respir Med. doi:10.1016/j.rmed.2024.107581
