Clinical remission of mild-to-moderate asthma: Rates, contributing factors, and stability

Clinical remission of mild-to-moderate asthma: Rates, contributing factors, and stability

Background: Although clinical remission (CR) of severe asthma has been extensively investigated, CR of mild-to-moderate asthma remains unexplored. Objective: This study aimed to determine CR rates, contributing factors, and stability in patients with mild-to-moderate asthma. Methods: We retrospectiv...

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Main Authors: Mana Ishizuka, MD, Naoya Sugimoto, MD, PhD, Konomi Kobayashi, MD, Yuri Takeshita, MD, PhD, Sahoko Imoto, MD, PhD, Yuta Koizumi, MD, PhD, Yusuke Togashi, MD, Yutaro Tanaka, MD, Maki Nagata, MD, Saya Hattori, MD, Yuki Uehara, MD, Yuki Suzuki, MD, PhD, Hikaru Toyota, MD, PhD, Satoru Ishii, MD, PhD, Hiroyuki Nagase, MD, PhD
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:Journal of Allergy and Clinical Immunology: Global
Subjects:
Clinical remission
mild asthma
moderate asthma
stability
practical guidelines for asthma management
pulmonary function
Online Access:http://www.sciencedirect.com/science/article/pii/S2772829325000323
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Summary:Background: Although clinical remission (CR) of severe asthma has been extensively investigated, CR of mild-to-moderate asthma remains unexplored. Objective: This study aimed to determine CR rates, contributing factors, and stability in patients with mild-to-moderate asthma. Methods: We retrospectively analyzed 263 patients with asthma. Three-component CR was defined as no exacerbation, no daily oral corticosteroid receipt, and an Asthma Control Test score equivalent to that of the well control; 4-component CR included these parameters plus forced expiratory volume in 1 second of ≥80% predicted. CR during the 1 year and stability of CR over 10 years were retrospectively analyzed in patients with mild-to-moderate and severe asthma. Results: The CR rates were significantly higher (4-component, 73.2%; 3-component, 81.0%) in patients with mild-to-moderate asthma compared with the CR rate in patients with severe asthma (4-component, 33.9%; and 3-component, 30.6%). A lower smoking index contributed to 3- and 4-component CR. Lower body mass index contributed to 3-component remission, and later onset and shorter asthma duration contributed to 4-component remission. In patients experiencing 4-component remission 10 years before, 80.3% maintained disease in remission; 89.1% of patients experiencing 3-component remission maintained disease in remission. In patients with disease that did not maintain 4-component CR after 10 years, predicted forced expiratory volume decreased, but no differences in inhaled corticosteroid and long-acting β-agonists/long-acting muscarinic antagonists receipt were detected between 10 years ago and the present. The current muscarinic antagonist receipt remained low, at 16.7%. Conclusion: CR, including normalized forced expiratory volume, is obtainable and sustainable in most Japanese patients with mild-to-moderate asthma. Assessing CR in these patients may help avoid undertreatment and reduce future risks.
ISSN:2772-8293

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