Asthma Remission by Age at Diagnosis and Gender in a Population-Based Study

Jasmin Honkamäki; Päivi Piirilä; Hanna Hisinger-Mölkänen; Leena E Tuomisto; Heidi Andersén; Heini Huhtala; Anssi Sovijärvi; Ari Lindqvist; Helena Backman; Bo Lundbäck; Eva Rönmark; Lauri Lehtimäki; Paula Pallasaho; Pinja Ilmarinen; Hannu Kankaanranta

doi:10.1016/j.jaip.2020.12.015

Asthma Remission by Age at Diagnosis and Gender in a Population-Based Study

J Allergy Clin Immunol Pract. 2021 May;9(5):1950-1959.e4. doi: 10.1016/j.jaip.2020.12.015. Epub 2020 Dec 15.

Authors

Affiliations

¹ Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
² Unit of Clinical Physiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.
³ Faculty of Medicine, University of Helsinki, Helsinki, Finland.
⁴ Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland.
⁵ Thoracic Oncology Unit, Tema Cancer, Karolinska University Hospital, Stockholm, Sweden.
⁶ Faculty of Social Sciences, Tampere University, Tampere, Finland.
⁷ Research Unit of Pulmonary Diseases, Helsinki University Hospital, University of Helsinki and Clinical Research Institute HUCH Ltd, Helsinki, Finland.
⁸ Department of Public Health and Clinical Medicine, Division of Occupational and Environmental Medicine/the OLIN Unit, Umeå University, Umeå, Sweden.
⁹ Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
¹⁰ Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Allergy Centre, Tampere University Hospital, Tampere, Finland.
¹¹ Primary Health Care Services, City of Espoo, Espoo, Finland.
¹² Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland; Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden. Electronic address: hannu.kankaanranta@tuni.fi.

PMID: 33338683
DOI: 10.1016/j.jaip.2020.12.015

Abstract

Background: Child-onset asthma is known to remit with high probability, but remission in adult-onset asthma is seemingly less frequent. Reports of the association between remission and asthma age of onset up to late adulthood are scarce.

Objective: To evaluate the association between asthma remission, age at diagnosis and gender, and assess risk factors of nonremission.

Methods: In 2016, a random sample of 16,000 subjects aged 20 to 69 years from Helsinki and Western Finland were sent a FinEsS questionnaire. Physician-diagnosed asthma was categorized by age at diagnosis to early- (0-11 years), intermediate- (12-39 years), and late-diagnosed (40-69 years) asthma. Asthma remission was defined by not having had asthma symptoms and not having used asthma medication in the past 12 months.

Results: Totally, 8199 (51.5%) responded, and 879 reported physician-diagnosed asthma. Remission was most common in early-diagnosed (30.2%), followed by intermediate-diagnosed (17.9%), and least common in late-diagnosed asthma (5.0%) (P < .001), and the median times from diagnosis were 27, 18.5, and 10 years, respectively. In males, the corresponding remission rates were 36.7%, 20.0%, and 3.4%, and in females, 20.4%, 16.6%, and 5.9% (gender difference P < .001). In multivariable binary logistic regression analysis, significant risk factors of asthma nonremission were intermediate (odds ratio [OR] = 2.15, 95% confidence interval: 1.37-3.36) and late diagnosis (OR = 11.06, 4.82-25.37) compared with early diagnosis, chronic obstructive pulmonary disease (COPD) (OR = 5.56, 1.26-24.49), allergic rhinitis (OR = 2.28, 1.50-3.46), and family history of asthma (OR = 1.86, 1.22-2.85). Results were similar after excluding COPD.

Conclusion: Remission was rare in adults diagnosed with asthma after age 40 years in both genders. Late-diagnosed asthma was the most significant independent risk factor for nonremission.

Keywords: Adult; Age of onset; Asthma; Early-onset; Gender; Late-onset; Population study; Remission.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Asthma* / diagnosis
Asthma* / epidemiology
Child
Female
Finland / epidemiology
Humans
Male
Middle Aged
Odds Ratio
Rhinitis, Allergic*
Risk Factors
Sex Factors
Young Adult