PT  - JOURNAL ARTICLE
AU  - Steve Turner
AU  - Nanda Prabhu
AU  - Rebecca Cutts
AU  - Keith Allen
AU  - Peter Helms
AU  - Anthony Seaton
AU  - Graham Devereux
TI  - Predictors of asthma symptom remission after five years of age
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - p1499
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/p1499.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/p1499.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Introduction: Childhood asthma is a common condition characterised by relapse and remission. Here we sought to identify the precision of physiological measurements made in 5-year-olds for predicting asthma outcome at 10 years of age.Methods: As part of a cohort study, 5 year old children attended a clinical assessment which included skin prick reactivity, spirometry and bronchodilator response. A respiratory symptom questionnaire was completed at ages 5 and 10 years. Children were categorised as having persistent asthma, early remittent asthma, later onset asthma or being non-asthmatic.Results: Of the 1924 originally recruited, questionnaire data were available in 808 children at both 5 and 10 years of age including 37 with persistent asthma, 30 with early remittent asthma and 33 with later onset asthma. Skin prick reactivity was determined in 483 5-year-olds, spirometry in 410, bronchodilator response (BDR) in 164 and FENO in 110. Atopy had sensitivity of 82% [95% CI 68, 92] and specificity of 57% [95% CI 42, 68] for predicting persistent asthma in symptomatic 5–year-olds and a sensitivity of 72% [95% CI 50, 87%] and specificity of 79% [95% CI 78-80] for predicting later onset asthma in asymptomatic 5-year-olds. Regardless of asthma status at 5 years, FENO >10.7ppb had a sensitivity of 62% and specificity of 89% for asthma at 10 years. Spirometry and BDR were not predictive of later asthma outcomesConclusions: In this community-based cohort, objective physiological measurements taken in 5-year-olds were able to predict asthma outcome in later childhood. The absence of atopy or elevated FENO in a young child with asthma or asthma-like symptoms may be helpful in predicting low risk for future asthma symptoms.