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
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772829325000323
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author 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
author_facet 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
author_sort Mana Ishizuka, MD
collection DOAJ
description 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.
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spelling doaj-art-ea420326e75a47a19dbda060a17cec212025-08-20T03:49:03ZengElsevierJournal of Allergy and Clinical Immunology: Global2772-82932025-05-014210043110.1016/j.jacig.2025.100431Clinical remission of mild-to-moderate asthma: Rates, contributing factors, and stabilityMana Ishizuka, MD0Naoya Sugimoto, MD, PhD1Konomi Kobayashi, MD2Yuri Takeshita, MD, PhD3Sahoko Imoto, MD, PhD4Yuta Koizumi, MD, PhD5Yusuke Togashi, MD6Yutaro Tanaka, MD7Maki Nagata, MD8Saya Hattori, MD9Yuki Uehara, MD10Yuki Suzuki, MD, PhD11Hikaru Toyota, MD, PhD12Satoru Ishii, MD, PhD13Hiroyuki Nagase, MD, PhD14Department of Medicine, Division of Respiratory Medicine and Allergology, Teikyo University School of Medicine, Tokyo, JapanCorresponding author: Naoya Sugimoto, MD, PhD, 173-8605, Division of Respiratory Medicine and Allergology, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, Japan.; Department of Medicine, Division of Respiratory Medicine and Allergology, Teikyo University School of Medicine, Tokyo, JapanDepartment of Medicine, Division of Respiratory Medicine and Allergology, Teikyo University School of Medicine, Tokyo, JapanDepartment of Medicine, Division of Respiratory Medicine and Allergology, Teikyo University School of Medicine, Tokyo, JapanDepartment of Medicine, Division of Respiratory Medicine and Allergology, Teikyo University School of Medicine, Tokyo, JapanDepartment of Medicine, Division of Respiratory Medicine and Allergology, Teikyo University School of Medicine, Tokyo, JapanDepartment of Medicine, Division of Respiratory Medicine and Allergology, Teikyo University School of Medicine, Tokyo, JapanDepartment of Medicine, Division of Respiratory Medicine and Allergology, Teikyo University School of Medicine, Tokyo, JapanDepartment of Medicine, Division of Respiratory Medicine and Allergology, Teikyo University School of Medicine, Tokyo, JapanDepartment of Medicine, Division of Respiratory Medicine and Allergology, Teikyo University School of Medicine, Tokyo, JapanDepartment of Medicine, Division of Respiratory Medicine and Allergology, Teikyo University School of Medicine, Tokyo, JapanDepartment of Medicine, Division of Respiratory Medicine and Allergology, Teikyo University School of Medicine, Tokyo, JapanDepartment of Medicine, Division of Respiratory Medicine and Allergology, Teikyo University School of Medicine, Tokyo, JapanDepartment of Medicine, Division of Respiratory Medicine and Allergology, Teikyo University School of Medicine, Tokyo, JapanDepartment of Medicine, Division of Respiratory Medicine and Allergology, Teikyo University School of Medicine, Tokyo, JapanBackground: 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.http://www.sciencedirect.com/science/article/pii/S2772829325000323Clinical remissionmild asthmamoderate asthmastabilitypractical guidelines for asthma managementpulmonary function
spellingShingle 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
Clinical remission of mild-to-moderate asthma: Rates, contributing factors, and stability
Journal of Allergy and Clinical Immunology: Global
Clinical remission
mild asthma
moderate asthma
stability
practical guidelines for asthma management
pulmonary function
title Clinical remission of mild-to-moderate asthma: Rates, contributing factors, and stability
title_full Clinical remission of mild-to-moderate asthma: Rates, contributing factors, and stability
title_fullStr Clinical remission of mild-to-moderate asthma: Rates, contributing factors, and stability
title_full_unstemmed Clinical remission of mild-to-moderate asthma: Rates, contributing factors, and stability
title_short Clinical remission of mild-to-moderate asthma: Rates, contributing factors, and stability
title_sort clinical remission of mild to moderate asthma rates contributing factors and stability
topic Clinical remission
mild asthma
moderate asthma
stability
practical guidelines for asthma management
pulmonary function
url http://www.sciencedirect.com/science/article/pii/S2772829325000323
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