Predicting whether a child will outgrow asthma has important implications for patients, parents and doctors. Past studies have estimated between 15% to 64% of patients with childhood asthma go into remission by early adulthood. In those studies asthma remission rates have been noted to vary widely by population, and remission has been associated with less allergenic sensitization, milder initial asthma severity and male sex. Asthma remission commonly occurs by the ages of 14 to 21 years.
In a recent study published in The Journal of Allergy and Clinical Immunology, researchers determined which baseline characteristics could determine which children have a higher likelihood to outgrow asthma by adulthood.
The main conclusions from the study determined:
- 26% of patients with mild to moderate asthma had clinical remission of disease by early adulthood.
- Baseline airflow obstruction measured by spirometry (pulmonary function test) was the greatest predictor of asthma remission. More than half the boys and 2/3 of the girls who performed greater than 90% on spirometry (using FEV1 and FVC ratio), were in remission by adulthood.
- Decreased airway responsiveness and lower serum eosinophil counts also were predictive of whether or not one will outgrow asthma.
Lung function measurements and serum eosinophil counts obtained in early childhood predict asthma remission in early adulthood. Pulmonary function testing (spirometry) should be performed in all patients with childhood asthma for clinical outcomes.
This study followed 879 children with mild to moderate asthma for an average of 12 years until early adulthood. Using the 3 parameters, lung spirometry, airway responsiveness (from methacholine challenge) and serum eosinophil counts (greater or less than 500), remission rates can be predicted.
Conclusions of the study showed a considerable minority of patients with persistent childhood asthma will have disease remission by adulthood. So it would be difficult to tell parents their child will outgrow asthma unless their spirometry results are over the 90% range and they have low eosinophil counts on lab work.