Prognosis of Allergic and Non-Allergic Asthma
Some studies indicate that atopy is less important as a predictor of severe asthma. But, remission is more uncommon in allergic asthma than in non-allergic asthma. The purpose of this study was to investigate the prognosis of asthma and risk factors for asthma onset, especially sensitization of specific allergens. A cohort of three age groups responded to a respiratory questionnaire in 1990 and 2003. At baseline, 2060 subjects who reported respiratory symptoms and 482 controls were investigated with interviews, spirometry and skin prick test. A total of 721 asthmatics and 976 subjects without respiratory disease were clinically verified. At follow-up in 2003, 340 subjects with persistent asthma and 186 subjects with asthma remission were identified while 76 subjects reported new asthma onset. Sensitisation to pets and a high symptom score were significant determinants of persistent asthma (ORs 3.23 [95% CI 1.9-5.67], and 5.76 [2.35-13.34] respectively), and onset of asthma, (ORs 2.65 [1.13-4.86.0], and 1.7 [1.21-2.35], respectively).
A high self-reported responsiveness to airway irritants (OR 1.6 [1.12-2.2]), and more asthma medications (OR 2.0 [1.3-2.9]) were additional risk factors for persistent asthma at the follow-up. Belonging to the older age group decreased the risk of having persistent asthma or asthma onset. In conclusion, the findings of this study show that asthmatics sensitized to pets have a more severe prognosis than asthmatics not sensitized to pets. Sensitization to pets was also a strong predictor for onset of asthma. Our study indicates that special care should be given to asthmatics who report having problems with a high number of airway irritants as such patients are more likely to suffer from persistent problems.
Anna Rask-Andersen1, Monica Uddenfeldt1, Erik Lampa1 and Christer Janson2
1Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden, 2Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden
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