Asthma incidence, remission, relapse and persistence: a population-based study in southern Taiwan

Abstract

BackgroundIn western countries, late-onset asthmatics are more severe than early-onset asthmatics in clinic-based studies. However, whether asthma occurrence rates were higher in late ages than in younger ages was inconclusive. This information is essentially lacking in Asian population.MethodsThe participants were schoolchildren’s parents recruited from 94 elementary and middle schools in 2004. A cross-sectional self-administered questionnaire was sent through the children to their parents to survey their respiratory health. We investigated typical asthma symptoms occurring at different ages and subsequent remission or relapse after the first asthma event. Person-years of the participants from birth to the time of survey were used as the denominator.ResultsAmong the 25,377 participants consisting of 949,807 total person-years, 860 reported ever having asthma. Highest incidences occurred at ages 0–12 and 36–40 years. The incidence of asthma was higher in males before puberty, and higher in females after puberty, with overall incidences 1.00 and 0.77 per 1000 person-years for females and males, respectively. Participants with late-onset asthma (onset age >12 years) comprised a large portion of adult current asthmatics. More than 52% of persistence or relapse was observed in early-onset asthma (onset age ≤12 years). The younger birth cohort had a more prominent later peak of asthma incidence than the older one.ConclusionsIn Asian population, asthma occurrence showed a U-shape age distribution with a prominent second peak in the thirties. A high proportion of early-onset asthma relapsed and most of late-onset asthma persisted or relapsed in adulthood.

Asthma in adolescence: Is there any news?

“…The natural course of asthma is heterogeneous and dynamic . Remission is common, mainly in late adolescence, with reported rates from 16% to 60% .…”

An expert consensus framework for asthma remission as a treatment goal

“…To date, remission of asthma has only been described as the spontaneous cessation of asthma disease activity (eg, due to the transition from childhood to adulthood) and not as a therapeutic target. [7][8][9][10] A consensus definition of asthma remission could become a new asthma treatment goal and allow further exploration and comparison of the efficacy of novel treatment regimens. 8 A comprehensive and pragmatic definition of remission as a treatment target must add value beyond the existing treatment goal of asthma control, which is based on current symptom control and future risk of adverse outcomes.…”

Severe asthma during childhood and adolescence: A longitudinal study

“…Recent data suggest that asthma-related hospitalizations might be lower in late adolescence (13-18 years old) and early adulthood (19-30 years old) than in earlier childhood and middle age. 6,7 However, longitudinal studies of children with severe asthma have not been performed. Because cross-sectional data show that boys are more likely than girls to have asthma and that women are more likely than men to have asthma, 3,8,9 we hypothesized that longitudinal analysis would reveal that asthma severity decreases in boys and increases in girls during adolescence.…”