Clinical course and remission rate in adult patients with atopic asthma in Chelyabinsk

Data on asthma remission in adults are scarce worldwide and have not been searched in Russian Federation.

The aim of the study was to describe clinical course and remission rate in adult patients with atopic asthma in Chelyabinsk.

Methods. A retrospective analysis of 313 outpatient records of patients with atopic asthma aged 18 to 70 years was carried out. The patients were followed from 1992 to 2018. The median duration of the follow-up was 8 (5; 15) years. Then, the patients were surveyed by phone. Asthma Control Test (AСT) was used in 181 (58%) of 313 respondents. Clinical remission of asthma was determined as being symptom-free with no need in inhaled corticosteroids (ICSs) and short-acting β2-agonists (SABAs) during ≥ 1 year.

Results. The median age of asthma onset was 14.5 (8; 2) years in males and 28 (24; 36) years in females (p < 0.001). The diagnosis was made 5 years after the onset of symptoms. Asthma severity was related to gender: mild asthma was seen more often in males compared to females (p = 0.008). Allergic rhinitis and asthma comorbidity was found in 78% of patients. The proportion of patients sensitized to pollen was 72%; tree pollen allergens were the main cause of seasonal allergy (in 51% of patients). Different combinations of sensitization to indoor, animal, and pollen allergens (polysensitization) were detected in 80% of patients. Clinical remission of atopic bronchial asthma was determined in 22.7% of cases. Asthma remission was not related to the patient’s gender or age of symptom onset. The median age of the remission group patients was 33 (28; 39.5) years vs 40 (29; 51) years in patients without remission (p = 0.015). Asthma remission was associated with normal body mass index (23 (21; 24) kg / m2 vs 25 (22; 29) kg / m2 (p = 0.007); allergen elimination (p < 0.001) and allergen-specific immunotherapy (p < 0.001).

Conclusion. Predicting the probability of asthma remission and identifying conditions required to achieve the remission could improve our knowledge about asthma natural course and could increase treatment efficacy and adherence of patients to the treatment. 

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