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Question clinique
Do children outgrow severe asthma?
L’Essentiel
This study found that nearly half of children who met the diagnostic criteria for severe asthma (see Synopsis for specific criteria) no longer had severe asthma after 3 years. No differences occurred in resolution rates between boys and girls or in association with baseline body mass index or lung function. 1b-
Référence
Plan de l'etude: Cohort (prospective)
Financement: Government
Cadre: Outpatient (specialty)
Sommaire
Investigators from 11 clinical centers identified 188 children, aged 6 to 17 years, who met the standard international diagnostic criteria for asthma between 2012 and 2015. At baseline, 111 (59%) of the children met the criteria for severe asthma, defined as remaining uncontrolled despite treatment with high-dose inhaled steroids plus a second controller and/or systemic steroids. Follow-up annual assessments occurred for 93.6%, 84.6%, and 71.8% of participants at 12, 24, and 36 months, respectively. The proportion of patients who met the criteria for severe asthma decreased steadily, with only 30% meeting the criteria for severe asthma at 3 years. Improvements occurred with regard to symptoms, controller medication requirements, exacerbations, and hospitalizations. No differences occurred in the probability of asthma resolution between male and female participants. An elevated eosinophil count of greater than or equal to 436 cells/uL predicted resolution (odds ratio = 2.75; 95% CI 1.02 - 7.43). Neither baseline lung function nor body mass index predicted resolution.
Reviewer
David C. Slawson, MD
Professor and Vice Chair of Family Medicine for Education and Scholarship
Atrium Health
Professor of Family Medicine, UNC Chapel Hill
Charlotte, NC