BACKGROUND: The knowledge of the natural history of asthma from birth to adulthood could provide important clues for its cause and for the understanding of epidemiologic findings. OBJECTIVE: This study is aimed at assessing the incidence and remission of asthma from birth to the age of 44 years by using data from 18,873 subjects involved in a large, nationally representative, cross-sectional study carried out in Italy from 1998 through 2000. METHODS: The onset of asthma was defined as the age at the first attack, and remission was considered present when a subject was neither under treatment nor had experienced an asthma attack in the last 24 months. Person-years and survival techniques were used for the analysis. RESULTS: The average annual incidence rate for the 1953 to 2000 period was 2.56/1000 persons per year. Incidence peaked in boys less than 10 years of age (4.38/1000 persons per year) and in women 30 years of age or older (3.1/1000 persons per year) and showed a generational increase (incident rate ratio = 2.63 and 95% CI = 2.20-3.12 for 1974-1979 vs 1953-1958 birth cohort). The overall remission rate was 45.8% (41.6% in women and 49.5% in men, P <.001). Asthmatic patients in remission had an earlier age at onset (7.8 vs 15.9 years, P <.001) and a shorter duration of the disease (5.6 vs 16.1 years, P <.001) than patients with current asthma. The probability of remission was strongly (P <.001) and inversely related to the age at onset (62.8% and 15.0% in the <10- and > or =20-years age-at-onset groups, respectively). CONCLUSION: With respect to its natural history, asthma presents 2 different forms: early-onset asthma, which occurs early in childhood, affects mainly boys, and has a good prognosis, and late-onset asthma, which generally occurs during or after puberty, mainly affects women, and has a poor prognosis. The minority of patients with early-onset asthma who do not remit represents more than 35% of patients with current asthma in the general young adult population.
BACKGROUND: The knowledge of the natural history of asthma from birth to adulthood could provide important clues for its cause and for the understanding of epidemiologic findings. OBJECTIVE: This study is aimed at assessing the incidence and remission of asthma from birth to the age of 44 years by using data from 18,873 subjects involved in a large, nationally representative, cross-sectional study carried out in Italy from 1998 through 2000. METHODS: The onset of asthma was defined as the age at the first attack, and remission was considered present when a subject was neither under treatment nor had experienced an asthma attack in the last 24 months. Person-years and survival techniques were used for the analysis. RESULTS: The average annual incidence rate for the 1953 to 2000 period was 2.56/1000 persons per year. Incidence peaked in boys less than 10 years of age (4.38/1000 persons per year) and in women 30 years of age or older (3.1/1000 persons per year) and showed a generational increase (incident rate ratio = 2.63 and 95% CI = 2.20-3.12 for 1974-1979 vs 1953-1958 birth cohort). The overall remission rate was 45.8% (41.6% in women and 49.5% in men, P <.001). Asthmatic patients in remission had an earlier age at onset (7.8 vs 15.9 years, P <.001) and a shorter duration of the disease (5.6 vs 16.1 years, P <.001) than patients with current asthma. The probability of remission was strongly (P <.001) and inversely related to the age at onset (62.8% and 15.0% in the <10- and > or =20-years age-at-onset groups, respectively). CONCLUSION: With respect to its natural history, asthma presents 2 different forms: early-onset asthma, which occurs early in childhood, affects mainly boys, and has a good prognosis, and late-onset asthma, which generally occurs during or after puberty, mainly affects women, and has a poor prognosis. The minority of patients with early-onset asthma who do not remit represents more than 35% of patients with current asthma in the general young adult population.
Authors: Christopher John Staniorski; Caroline P E Price; Ava R Weibman; Kevin C Welch; David B Conley; Stephanie Shintani-Smith; Whitney W Stevens; Anju T Peters; Leslie Grammer; Alcina K Lidder; Robert P Schleimer; Robert C Kern; Bruce K Tan Journal: Int Forum Allergy Rhinol Date: 2018-01-05 Impact factor: 3.858
Authors: Piush J Mandhane; Justina M Greene; Jan O Cowan; D Robin Taylor; Malcolm R Sears Journal: Am J Respir Crit Care Med Date: 2005-04-01 Impact factor: 21.405
Authors: Nicole Le Moual; Valérie Siroux; Isabelle Pin; Francine Kauffmann; Susan M Kennedy Journal: Am J Respir Crit Care Med Date: 2005-06-16 Impact factor: 21.405
Authors: Sonali J Bracken; Alexander J Adami; Steven M Szczepanek; Mohsin Ehsan; Prabitha Natarajan; Linda A Guernsey; Neda Shahriari; Ektor Rafti; Adam P Matson; Craig M Schramm; Roger S Thrall Journal: Int Arch Allergy Immunol Date: 2015-04-28 Impact factor: 2.749
Authors: Ketan Shankardass; Rob McConnell; Michael Jerrett; Joel Milam; Jean Richardson; Kiros Berhane Journal: Proc Natl Acad Sci U S A Date: 2009-07-20 Impact factor: 11.205