Prognosis

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Astma bij volwassenen: diagnose en monitoring in de eerste lijnPublished by: Werkgroep Ontwikkeling Richtlijnen Eerste Lijn (Worel)Last published: 2020Asthme chez l’adulte : diagnostic et surveillance en soins de santé primairesPublished by: Groupe de Travail Développement de recommmandations de première ligneLast published: 2020

The life expectancy of people with controlled asthma is similar to that for the general population.

According to the Global Burden of Disease Study 2022, asthma caused an estimated 21.6 million disability-adjusted life years and 0.46 million deaths in 2019; since 1990, these had decreased significantly by 51.3% and 42.5%, respectively.[5][6]

Male sex, single marital status, and hypertension were found to be correlated with a higher risk of all-cause mortality in a Danish cohort study of adults with incident asthma.[285] Conversely, greater levels of self-reported physical activity were associated with a lower all-cause mortality risk.[285]

Remission

This is an area of ongoing debate.

Remission is possible either on treatment (inhaled corticosteroids, biologics, allergen immunotherapies) or off treatment.[3][286][287] A US consensus statement has proposed that patients meeting the following criteria over a 12-month period (including those receiving monoclonal antibody therapy) may be considered in remission:[288]

  • No exacerbations

  • No missed work or school

  • Stable and optimized pulmonary function results on ≥2 measurements

  • Continued use of controller therapies, only at low-medium dose of ICS, or less

  • Asthma Control Test >20, Asthma Impairment and Risk Questionnaire <2, or Asthma Control Questionnaire <0.75 on ≥2 measurements

  • Symptoms requiring 1-time reliever therapy no more than once a month

It should be noted that remission is not cure, and that asthma may recur later in life.[3]

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