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]GBD 2019 Chronic Respiratory Diseases Collaborators. Global burden of chronic respiratory diseases and risk factors, 1990-2019: an update from the Global Burden of Disease Study 2019. EClinicalMedicine. 2023 May;59:101936.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7614570
http://www.ncbi.nlm.nih.gov/pubmed/37229504?tool=bestpractice.com
[6]Global Asthma Network. The global asthma report 2022 [internet publication].
https://globalasthmareport.org
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]Tupper OD, Andersen ZJ, Ulrik CS. Demographic, lifestyle and comorbid risk factors for all-cause mortality in a Danish cohort of middle-aged adults with incident asthma. BMJ Open. 2021 Oct 4;11(10):e049243.
https://www.doi.org/10.1136/bmjopen-2021-049243
http://www.ncbi.nlm.nih.gov/pubmed/34607861?tool=bestpractice.com
Conversely, greater levels of self-reported physical activity were associated with a lower all-cause mortality risk.[285]Tupper OD, Andersen ZJ, Ulrik CS. Demographic, lifestyle and comorbid risk factors for all-cause mortality in a Danish cohort of middle-aged adults with incident asthma. BMJ Open. 2021 Oct 4;11(10):e049243.
https://www.doi.org/10.1136/bmjopen-2021-049243
http://www.ncbi.nlm.nih.gov/pubmed/34607861?tool=bestpractice.com
Remission
This is an area of ongoing debate.
Remission is possible either on treatment (inhaled corticosteroids, biologics, allergen immunotherapies) or off treatment.[3]Global Initiative for Asthma. 2024 global strategy for asthma management and prevention. May 2024 [internet publication].
https://ginasthma.org/wp-content/uploads/2024/05/GINA-2024-Strategy-Report-24_05_22_WMS.pdf
[286]Lommatzsch M, Buhl R, Canonica GW, et al. Pioneering a paradigm shift in asthma management: remission as a treatment goal. Lancet Respir Med. 2024 Feb;12(2):96-9.
http://www.ncbi.nlm.nih.gov/pubmed/38071999?tool=bestpractice.com
[287]Shackleford A, Heaney LG, Redmond C, et al. Clinical remission attainment, definitions, and correlates among patients with severe asthma treated with biologics: a systematic review and meta-analysis. Lancet Respir Med. 2025 Jan;13(1):23-34.
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(24)00293-5/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/39549709?tool=bestpractice.com
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]Blaiss M, Oppenheimer J, Corbett M, et al. Consensus of an American College of Allergy, Asthma, and Immunology, American Academy of Allergy, Asthma, and Immunology, and American Thoracic Society workgroup on definition of clinical remission in asthma on treatment. Ann Allergy Asthma Immunol. 2023 Dec;131(6):782-5.
http://www.ncbi.nlm.nih.gov/pubmed/37690606?tool=bestpractice.com
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]Global Initiative for Asthma. 2024 global strategy for asthma management and prevention. May 2024 [internet publication].
https://ginasthma.org/wp-content/uploads/2024/05/GINA-2024-Strategy-Report-24_05_22_WMS.pdf