Background: The knowledge of the natural history of asthma from birth to adulthood could provide important clues for its cause and for the understanding of epidemiologic findings. Objective: This study is aimed at assessing the incidence and remission of asthma from birth to the age of 44 years by using data from 18,873 subjects involved in a large, nationally representative, cross-sectional study carried out in Italy from 1998 through 2000. Methods: The onset of asthma was defined as the age at the first attack, and remission was considered present when a subject was neither under treatment nor had experienced an asthma attack in the last 24 months. Person-years and survival techniques were used for the analysis. Results: The average annual incidence rate for the 1953 to 2000 period was 2.56/1000 persons per year. Incidence peaked in boys less than 10 years of age (4.38/1000 persons per year) and in women 30 years of age or older (3.1/1000 persons per year) and showed a generational increase (incident rate ratio = 2.63 and 95% CI = 2.20-3.12 for 1974-1979 vs 1953-1958 birth cohort). The overall remission rate was 45.8% (41.6% in women and 49.5% in men, P < .001). Asthmatic patients in remission had an earlier age at onset (7.8 vs 15.9 years, P < .001) and a shorter duration of the disease (5.6 vs 16.1 years, P < .001) than patients with current asthma. The probability of remission was strongly (P < .001) and inversely related to the age at onset (62.8% and 15.0% in the <10- and ≥20-years ageat- onset groups, respectively). Conclusion:With respect to its natural history, asthma presents 2 different forms: early-onset asthma, which occurs early in childhood, affects mainly boys, and has a good prognosis, and late-onset asthma, which generally occurs during or after puberty, mainly affects women, and has a poor prognosis. The minority of patients with early-onset asthma who do not remit represents more than 35% of patients with current asthma in the general young adult population.

Incidence and remission of asthma: A retrospective study on the natural history of asthma in Italy

ROMANO, Canzio;DALMASSO, Paola;BONO, Roberto;BRUSSINO, Luisa;BUCCA, Caterina;ROLLA, Giovanni;
2002

Abstract

Background: The knowledge of the natural history of asthma from birth to adulthood could provide important clues for its cause and for the understanding of epidemiologic findings. Objective: This study is aimed at assessing the incidence and remission of asthma from birth to the age of 44 years by using data from 18,873 subjects involved in a large, nationally representative, cross-sectional study carried out in Italy from 1998 through 2000. Methods: The onset of asthma was defined as the age at the first attack, and remission was considered present when a subject was neither under treatment nor had experienced an asthma attack in the last 24 months. Person-years and survival techniques were used for the analysis. Results: The average annual incidence rate for the 1953 to 2000 period was 2.56/1000 persons per year. Incidence peaked in boys less than 10 years of age (4.38/1000 persons per year) and in women 30 years of age or older (3.1/1000 persons per year) and showed a generational increase (incident rate ratio = 2.63 and 95% CI = 2.20-3.12 for 1974-1979 vs 1953-1958 birth cohort). The overall remission rate was 45.8% (41.6% in women and 49.5% in men, P < .001). Asthmatic patients in remission had an earlier age at onset (7.8 vs 15.9 years, P < .001) and a shorter duration of the disease (5.6 vs 16.1 years, P < .001) than patients with current asthma. The probability of remission was strongly (P < .001) and inversely related to the age at onset (62.8% and 15.0% in the <10- and ≥20-years ageat- onset groups, respectively). Conclusion:With respect to its natural history, asthma presents 2 different forms: early-onset asthma, which occurs early in childhood, affects mainly boys, and has a good prognosis, and late-onset asthma, which generally occurs during or after puberty, mainly affects women, and has a poor prognosis. The minority of patients with early-onset asthma who do not remit represents more than 35% of patients with current asthma in the general young adult population.
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de Marco R, Locatelli F, Cerveri I, Bugiani M, Marinoni A, Giammanco G, for the Italian Study on Asthma in Young Adults study group Principal researchers: O. Buriani, R. Cavallini, C. Saletti, M. Cellini, M. Faustini, A. de Togni (Ferrara); A. Marinoni, A. Carolei, C. Montomoli, S. Villani, M. Comelli, M. Ponzio, M. Grassi, C. Rezzani, L. Casali, I. Cerveri, M. C. Zoia, A. Corsico, S. Colato, G. Moscato, L. Perfetti (Pavia); L. Carrozzi, G. Viegi, F. Pistelli, F. Di Pede, P. L. Paggiaro, A. Santolicandro, P. Giovannetti (Pisa); F. Ginesu, P. Pirina, S. Ostera, G. P. Pinna, A. Farre, S. Imparato (Sassari); R. Dallari, E. Turrini, M. Foglia (Sassuolo); G. Giammanco, S. Pignato, A. Rotondo, A. Cuspilici (Siracusa); M. Bugiani, P. Piccioni, A. Carosso, W. Arossa, E. Caria, G. Castiglioni, E. Migliore, C. Romano, D. Fabbro, G. Ciccone, C. Magnani, P. Dalmasso, R. Bono, G. Gigli, A. Giraudo, M. C. Brussino, C. Bucca, G. Rolla (Turin); P. Struzzo, U. Orefice, M. Schneider, F. Chittaro, D. Peresson (Udine); R. de Marco, G. Verlato, S. Accordini, M. E. Zanolin, F. Locatelli, L. Cazzoletti, L. Battisti, C. Pattaro, A. Poli, N. Dorigo, S. Cantarelli, D. Ciresola, V. Lo Cascio, M. Olivieri, M. Ferrari, C. Biasin (Verona); P. Lauriola, G. Danielli, D. Sesti, E. Ghigli (ARPA Emilia-Romagna); P. Natale, M. Grosa (ARPA Piemonte); A. Tacconi, P. Frontero, A. Salomoni (ARPA Veneto).
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2318/117372
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