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[Prognosis of bronchial asthma]
A Dierkes-Globisch1, R Merget, X Baur
1Berufsgenossenschaftlichen Kliniken Bergmannsheil, Bochum.
Versicherungsmedizin
|May 20, 1998
Summary
Asthma prognosis remains unclear, with variable remission rates and a 30% relapse risk even after symptom resolution. Early severe disease, atopy, and smoking are linked to poorer outcomes.
Area of Science:
- Pulmonology
- Allergy and Immunology
- Epidemiology
Context:
- The long-term prognosis of asthma, particularly after adolescence, is not well-established.
- While some adolescents experience disease remission, persistent bronchial hyperresponsiveness is common.
- Relapse rates in asymptomatic adolescents suggest ongoing underlying disease activity.
Purpose:
- To review and synthesize current knowledge regarding asthma prognosis.
- To identify key risk factors associated with poor asthma outcomes.
- To highlight areas requiring further research, including environmental influences.
Summary:
- Asthma remission in adolescence varies widely (20-80%), with a notable 30% relapse rate in previously asymptomatic individuals.
- Predictors of poor prognosis include early severe disease, atopy, atopic dermatitis, high bronchial hyperresponsiveness, impaired lung function, and smoking (active/passive).
- The roles of gender, age at onset, and viral infections in asthma prognosis require further investigation.
Impact:
- Informs clinical management by identifying high-risk asthma patients.
- Highlights the need for continued monitoring even in asymptomatic individuals.
- Guides future research priorities for understanding and improving asthma long-term outcomes.