Abstract
Background: While many preschoolers with asthma experience remission, it remains unclear what drives disease evolution. We assessed if asthma control in the 2 years after diagnosis was associated with remission.
Methods: We conducted a retrospective cohort study of children born from 1990-2013 in 4 Canadian provinces, aged 1-5 years at asthma diagnosis, with sustained disease activity. Sustained activity was defined as ≥1 medical visit or treatment for asthma every 6 months for at least 2 years within the 3 years post-diagnosis (cohort entry). Remission was defined as 2 consecutive years of no asthma treatment, medical visits, or hospitalizations. Cox models served to assess if asthma control patterns in the 2 years post-diagnosis, ascertained over 4 consecutive 6-month periods with a validated Pediatric Asthma Control Index, were associated with time-to-remission, adjusting for covariates. A random effects model summarized Hazard Ratios across provinces.
Results: Of the 94,805 children with asthma, 45,331 (47.8%) entered the cohort. Compared to those controlled throughout, children with improving, variable, worsening control, and out-of-control asthma had decreasing hazards of remission in a dose-response pattern, after adjusting for covariates (Figure).
Conclusion: Poorer asthma control in the 2 years post-diagnosis is associated with a lower rate of remission, suggesting a potential window of opportunity to alter disease evolution in preschoolers.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA5057.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019