@article{15c7db14c463415d9c53c2c996ea05ad,
title = "Severe asthma during childhood and adolescence: A longitudinal study",
abstract = "Background: Morbidity and mortality associated with childhood asthma are driven disproportionately by children with severe asthma. However, it is not known from longitudinal studies whether children outgrow severe asthma. Objective: We sought to study prospectively whether well-characterized children with severe asthma outgrow their asthma during adolescence. Methods: Children with asthma were assessed at baseline with detailed questionnaires, allergy tests, and lung function tests and were reassessed annually for 3 years. The population was enriched for children with severe asthma, as assessed by the American Thoracic Society/European Respiratory Society guidelines, and subject classification was reassessed annually. Results: At baseline, 111 (59%) children had severe asthma. Year to year, there was a decrease in the proportion meeting the criteria for severe asthma. After 3 years, only 30% of subjects met the criteria for severe asthma (P <.001 compared with enrollment). Subjects experienced improvements in most indices of severity, including symptom scores, exacerbations, and controller medication requirements, but not lung function. Surprisingly, boys and girls were equally likely to has resolved asthma (33% vs 29%). The odds ratio in favor of resolution of severe asthma was 2.75 (95% CI, 1.02-7.43) for those with a peripheral eosinophil count of greater than 436 cells/μL. Conclusions: In longitudinal analysis of this well-characterized cohort, half of the children with severe asthma no longer had severe asthma after 3 years; there was a stepwise decrease in the proportion meeting severe asthma criteria. Surprisingly, asthma severity decreased equally in male and female subjects. Peripheral eosinophilia predicted resolution. These data will be important for planning clinical trials in this population.",
keywords = "Severe asthma, adolescence, eosinophilia, lung function",
author = "Ross, {Kristie R.} and Ritika Gupta and DeBoer, {Mark D.} and Joe Zein and Phillips, {Brenda R.} and Mauger, {David T.} and Chun Li and Myers, {Ross E.} and Wanda Phipatanakul and Fitzpatrick, {Anne M.} and Ly, {Ngoc P.} and Bacharier, {Leonard B.} and Jackson, {Daniel J.} and Celed{\'o}n, {Juan C.} and Allyson Larkin and Elliot Israel and Bruce Levy and Fahy, {John V.} and Mario Castro and Bleecker, {Eugene R.} and Deborah Meyers and Moore, {Wendy C.} and Wenzel, {Sally E.} and Jarjour, {Nizar N.} and Erzurum, {Serpil C.} and Teague, {W. Gerald} and Benjamin Gaston",
note = "Funding Information: Disclosure of potential conflict of interest: K. R. Ross reports funding from AstraZeneca to their institution for asthma research. W. Phipatanakul reports consultancy fees from Regeneron, Genentech, Novartis, Teva, and Sanofi; receives funding or supplies from Genentech, Novartis, Lincoln Diagnostics, ALK-Abell{\'o}, Thermo Fisher, Monoghan, Kaleo, and GlaxoSmithKline; and served as a speaker for GlaxoSmithKline and Genentech. D. J. Jackson reports receiving grants from GlaxoSmithKline, the National Institute for Infectious Diseases (NIAID), and the National Heart, Lung, and Blood Institute (NHLBI); has received personal fees for Data Safety Monitoring Board service from Pfizer; has received honorarium for consulting from Novartis, Sanofi-Regeneron, Vifor Pharma, and AstraZeneca. J. C. Celed{\'o}n has received research materials from GlaxoSmithKline and Merck (inhaled steroids) and Pharmavite (vitamin D and placebo capsules) to provide medications free of cost to participants in National Institutes of Health (NIH)–funded studies unrelated to the current work. J. V. Fahy reports personal fees from Boehringer Ingelheim, Pieris, Entrinsic Health Solutions, Arrowhead Pharmaceuticals, and Gossamer. W. C. Moore serves on advisory boards sponsored by AstraZeneca, GlaxoSmithKline, Sanofi, and Regeneron and reports work with Clinical trials sponsored by Novartis, Gossamer, and Cumberland Pharmaceuticals. S. E. Wenzel has consulted for AstraZeneca, Genentech, GlaxoSmithKline, and Sanofi Aventis and has participated in multicenter clinical trials for AstraZeneca, GlaxoSmithKline, Novartis, and Sanofi Aventis; and has received financial support from SARP from an unrestricted Boehringer Ingelheim grant. S. C. Erzurum serves on the Pulmonary Disease Board of ABIM. The rest of the authors declare that they have no relevant conflicts of interest.Principal investigators (PIs)/co-PIs funded by the National Institutes of Health/National Heart, Lung, and Blood Institute SARP were as follows: Eugene R. Bleecker, PI, Wake Forest University; Mario Castro, PI, Washington University; John V. Fahy, PI, University of California–San Francisco; Elliot Israel and Bruce Levy, Co-PIs, Brigham and Women's Hospital; Benjamin Gaston, PI, Case Western University of Virginia–Cleveland Consortium; Serpil Erzurum, Co-PI, Cleveland Clinic, Virginia–Cleveland Consortium; W. Gerald Teague, Co-PI, University of Virginia, Virginia-Cleveland Consortium; Nizar N. Jarjour, PI, University of Wisconsin; Sally E. Wenzel, PI, University of Pittsburgh; David T. Mauger, PI, Data Coordinating Center, Penn State University. The authors acknowledge the contributions of the study coordinators and staff at each of the clinical centers and the data coordinating center, as well as all the study participants, who have been integral to the success of SARP. The authors also appreciate the administrative assistance of Ms Kenzie Mahan. Publisher Copyright: {\textcopyright} 2019 The Authors",
year = "2020",
month = jan,
doi = "10.1016/j.jaci.2019.09.030",
language = "English",
volume = "145",
pages = "140--146.e9",
journal = "Journal of Allergy and Clinical Immunology",
issn = "0091-6749",
number = "1",
}