A 12-year prognosis of adult-onset asthma: Seinäjoki Adult Asthma Study. (August 2016)

• Record Type: Journal Article
• Authors: Tuomisto, Leena E.; Ilmarinen, Pinja; Niemelä, Onni; Haanpää, Jussi; Kankaanranta, Terhi; Kankaanranta, Hannu
• Is Part Of: Respiratory medicine. Volume 117(2016)
• Page Start: 223
• Page End: 229
• Publication Date: 2016-08
• Subjects: Asthma -- Adult -- Follow-up -- Remission -- Control -- Eosinophils; BMI Body mass index -- FeNO Fraction of NO in exhaled air -- ICS Inhaled corticosteroid; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2016.06.017
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Rationale: Long-term prognosis of adult-onset asthma is poorly known. Objective: To evaluate 12-year prognosis of adult-onset asthma and the factors associated with disease prognosis. Methods: Seinäjoki Adult-onset Asthma Study (SAAS) is a 12-year real-life single-center follow-up study of new-onset asthma diagnosed at adult age and treated in primary and specialized care. Remission was defined by no symptoms and no asthma medication use for 6 months. Asthma control was evaluated according to Global Initiative for Asthma 2010. Factors associated with current asthma control were analyzed by multinomial multivariate logistic regression. Main results: A total of 203 patients (79% of the baseline population) were followed for 12 years. Remission occurred in 6 (3%) patients. In 34% asthma was controlled, in 36% it was partially controlled and in 30% uncontrolled. Uncontrolled asthma was predicted by elevated body-mass index at baseline, smoking (pack-years) and current allergic or persistent rhinitis. Elevated blood eosinophils and good lung function (FEV1 ) at baseline protected from uncontrolled asthma. In contrast, gender, age at the onset or baseline symptoms (Airways Questionnaire 20) were not significant predictors of uncontrolled disease. Conclusions: During a 12-year follow-up, remission of adult-onset asthma was rare occurring in only 3% of patients. The majority of patients (66%) presented either with uncontrolled or partially controlled asthma. This study is registered at ClinicalTrials.gov with identifier numberNCT02733016 . Highlights: Prognosis of adult-onset asthma remains unclear, there has been a lack of real-life studies including also smokers. This manuscript presents first results of our prospective long-term study of specialist diagnosed adult-onset asthma patients. Our results show that remission of adult-onset asthma is rare (3%) and only one third reaches control. Good lung function and elevated eosinophils at baseline protected from uncontrolled asthma. Pack-years, current persistent rhinitis and baseline elevated BMI predicted uncontrolled asthma 12 years later.