Nearly 50% of children with severe asthma no longer meet the criteria for severe disease after 3 years

Reference

Ross KR, Gupta R, DeBoer MD, et al. Severe asthma during childhood and adolescence: A longitudinal study. J Allergy Clin Immunol 2020;145(1):140-146.

Synopsis

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.