Asthma resolved in 65% of children in a 40-year cohort study

A Tasmanian population-based cohort study enrolled 9,000 7-year-old schoolchildren in 1968. The outcome measure was asthma remission, defined as no asthma attack for 2 years and no current asthma medication use, or no self-reported asthma in adult life but with parent-reported childhood asthma.

Asthma had remitted in 65% of children.

Factors negatively associated with asthma remission:

- childhood onset (OR 0.38) and later-onset allergic rhinitis (0.42)
- childhood onset (0.66) and later-onset eczema (0.66)
- maternal asthma (0.66)
- childhood chronic bronchitis (0.56)

- passive smoking (0.75) and lower socio-economic status (less convincing evidence)

Some of the risk factors discussed in the study are part of the allergic (atopic) march shown below:



Allergic (atopic) march (click here to enlarge the image).

Childhood-onset asthma (3.76) was more likely to remit than adult-onset asthma. Gender did not influence remission.

While inherited factors cannot be changed, the effect of allergic rhinitis or eczema on asthma remission might be altered by early, aggressive treatment. Every effort should be made to lessen passive exposure to tobacco smoke.

References:

Factors influencing asthma remission: a longitudinal study from childhood to middle age. Thorax 2011;66:508-513 doi:10.1136/thx.2010.146845