Remission of Childhood Asthma after Entering the Second Decade of Life: A Hospital Based Cohort
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Abstract
Asthma is the most common chronic disease in children. The natural history of asthma is often characterized by periods of remission and relapse. The aim of this study was to determine the remission rate of asthmatic children after entering the second decade of life and remission related factors in a hospital–based cohort.
The study population was asthmatic children who were diagnosed, registered and followed up in outpatient pediatric clinic of a university hospital in Ahvaz, Iran. Remission was assessed in the age of 11 to 15 years-old if ≥ 5 years passed from the time of diagnosis. Clinical remission was defined as the absence of asthma symptoms for at least one year without the use of inhaled corticosteroids and short acting β2 agonists.
In the cases with clinical remission, spirometry and exercise tests were conducted to document complete remission. The study included 197 adolescents (mean age of 13.1±1.9 years). Clinical remissions were found in 71 cases (%36) but according to spirometry criteria,65 children (33%) were in complete remission. There was no significant difference between the genders. The remission rate was positively correlated with age of onset, and inversely correlated with family history of asthma, atopic dermatitis, hospitalization due to asthma, passive smoking and the need to use long-term inhaled corticosteroid.
Based on this study, approximately one third of asthmatic children showed remission up to 15 years of age which is a moderate rate compared to other studies.
1. Akinbami LJ, schoendorf KC. Trends in childhood Asthma: prevalence, health care utilization and mortality. Pediatrics 2002; 110(2):315-22.
2. To T, Gershon A, Wang C, Dell S, Cucutto L. persistence and Remission in childhood Asthma. Arch Pediatr Adolesc Med 2007; 161(12):1197-204.
3. Spahn JD, covar R. Clinical assessment of asthma progression in children and adults. J Allergy clin immunol 2008; 121(3):548-57.
4. Kokkonea J, Linna O. The state of childhood Asthma in young adulthood. Eur Respir J 1993; 6(5):657- 61.
5. Bronnimann S, Burrow B. A prospective study of the natural history of asthma remission and relapse rates. Chest 1986: 90(4):480-4.
6. Gerritsen J, Koeter GH, Postma DS, Schouter JP, Knol K.Prognosis of asthma from childhood to adulthood. Am Rev Respir Dis 1989; 140(5):1325-30.
7. Sears MR, Greene JM, Willan AR, Wiecek EM, Taylor DR, Flannery EM, et al. A Longitudinal, Population – based cohort of childhood asthma followed to adulthood. N Engl J Med 2003; 349(15):1414-22.
8. Toelle BG, Xuan W, peat JK, marks GB. Childhood factors that predict asthma in young adulthood. Eur Respir J 2004; 23(1):66-70.
9. Jenkins MA, Hopper JL, Bowes G, Carlin JB, Flander LB, Giles GG. Factors in childhood as predictors of asthma in adult life. BMJ 1994; 309(6947):90-3.
10. Withers NJ, low L, Holgate ST, Clough JB. The natural history of respiratory symptoms in a cohort of adolescents. Am J Respire Crit Care Med 1998;158(2):352-7.
11. Morais-Almeida M, Gaspar A, Pires G, Prates S, Rosado- Pinto J. Risk factors for asthma symptoms at school age: an 8-year prospective study. Allergy asthma proc 2007;28(2):183-9.
12. Rhodes HL, Thomas P, Sporik R, Holgate ST, cogswell JJ. A birth cohort study of subjects at risk of atopy: twenty two year follow – up of wheeze and atopic status. Am J Respir Crit Care Med 2002; 165(2):176-80.
13. Guerra S, Wright AL, Morgan WJ, Sherrill DL, Holberg CJ, martinez FD. Persistence of Asthma symptoms during adolescence: role of obesity and age of the onset of puberty. Am J Respir Crit Care Med 2004; 170(1):78-85.
14. Masjedi MR, Fadaizadeh L, Najafizadeh K, Dokouhaki P.Prevalence and Severity of Asthma Symptoms in Children of Tehran, International Study of Asthma and Allergies in Childhood (ISAAC). Iran J Allergy Asthma Immunol 2004; 3(1):25-30.
15. Liu AH, Covar RA, Spahn JD, Leung DYM. Childhood Ashma in: Kliegman RM, Behrman RE, Jenson HB, Stanton BF. Nelson Textbook of Pediatrics.18th ed. Philadelphia: Saunders, Elsevier; 2007:953-70.
16. Porsbjerg C, Von linstow ML, Suppli C, Nepper- Christensen S, Backer V. Risk factors for onset of asthma. A 12-year prospective follow– up study. Chest 2006; 129(2):309-16.
17. Godden D.J, Ross S, Abdalla M, McMurray D, Douglas A, Oldman D, et al. Outcome of wheeze in childhood: symptoms and pulmonary function 25 years later. Am J Respir Crit Care Med 1994; 149(1):106-12.
18. Kupczyk M, Kuprys I, Gorski P, Kuna P. Long-term deterioration of lung function in asthmatic outpatients. Respiration 2004; 71(3):233-40.
19. Juniper EF, Kline PA, Vanzieleghem MA, Hargreave FE.Reduction of budesonide after a year of increased use: a randomized controlled trial to evaluate whether improvements in airway responsiveness and clinical asthma are maintained. J Allergy Clin Immunol 1991;87(2):483-9.
20. Haahtela T, Jarvinen M , Kava T, Kiviranta K, Koskinen S, Lehtonen k, et al. Effects of reducing or discontinuing inhaled budesonide in patients with mild asthma . N Engl J Med 1994; 331(11):700-5.
21. Van Essen- Zandvliet EE, Hughes MD, Waalkens HJ, Duiverman EJ, kerrebijn KF. Remission of childhood asthma after long-term treatment with an corticosteroid (budesonide): can it be achieved? Dutch CNSLD Study Group. Eur Respire J 1994; 7(1):63-8.
22. Waalkens HJ, Van Essen-Zandvliet EE, Hughes MD, Gerritsen J, Duiverman EJ, Knol K, et al. Cessation of long-term treatment with inhaled corticosteroid (budesonide) in children with asthma results in deterioration. Am Rev Respir Dis 1993; 148(5):1252-7.
23. Covar RA, Spahn JD, Murphy JR, Szefler SJ. Progression of asthma measured by lung function in the Childhood Asthma Management Program. Am J Respir Crit Care Med 2004; 170(3):234-41.
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| Issue | Vol 12, No 2 (2013) | |
| Section | Articles | |
| Keywords | ||
| Asthma Children Remission rate | ||
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