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Asthma remission: what is it and how can it be achieved?

Asthma treatment goals currently focus on symptom and exacerbation control rather than remission. Remission is not identical to cure, but is a step closer. This review considers the current definitions of remission in asthma, the prevalence and predictors, the pathophysiology of remission, the possi...

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Autores principales: Thomas, Dennis, McDonald, Vanessa M., Pavord, Ian D., Gibson, Peter G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Respiratory Society 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9630609/
https://www.ncbi.nlm.nih.gov/pubmed/35361633
http://dx.doi.org/10.1183/13993003.02583-2021
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author Thomas, Dennis
McDonald, Vanessa M.
Pavord, Ian D.
Gibson, Peter G.
author_facet Thomas, Dennis
McDonald, Vanessa M.
Pavord, Ian D.
Gibson, Peter G.
author_sort Thomas, Dennis
collection PubMed
description Asthma treatment goals currently focus on symptom and exacerbation control rather than remission. Remission is not identical to cure, but is a step closer. This review considers the current definitions of remission in asthma, the prevalence and predictors, the pathophysiology of remission, the possibility of achieving it using the available treatment options, and the future research directions. Asthma remission is characterised by a high level of disease control, including the absence of symptoms and exacerbations, and normalisation or optimisation of lung function with or without ongoing treatment. Even in those who develop a symptomatic remission of asthma, persistent pathological abnormalities are common, leading to a risk of subsequent relapse at any time. Complete remission requires normalisation or stabilisation of any underlying pathology in addition to symptomatic remission. Remission is possible as part of the natural history of asthma, and the prevalence of remission in the adult asthma population varies between 2% and 52%. The factors associated with remission include mild asthma, better lung function, better asthma control, younger age, early-onset asthma, shorter duration of asthma, milder bronchial hyperresponsiveness, fewer comorbidities and smoking cessation or never smoking. Although previous studies have not targeted treatment-induced remission, there is some evidence to show that the current long-term add-on therapies such as biologics and azithromycin can achieve some criteria for asthma remission on treatment, at least in a subgroup of patients. However, more research is required. Long-term remission could be included as a therapeutic goal in studies of asthma treatments.
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spelling pubmed-96306092022-11-04 Asthma remission: what is it and how can it be achieved? Thomas, Dennis McDonald, Vanessa M. Pavord, Ian D. Gibson, Peter G. Eur Respir J Series Asthma treatment goals currently focus on symptom and exacerbation control rather than remission. Remission is not identical to cure, but is a step closer. This review considers the current definitions of remission in asthma, the prevalence and predictors, the pathophysiology of remission, the possibility of achieving it using the available treatment options, and the future research directions. Asthma remission is characterised by a high level of disease control, including the absence of symptoms and exacerbations, and normalisation or optimisation of lung function with or without ongoing treatment. Even in those who develop a symptomatic remission of asthma, persistent pathological abnormalities are common, leading to a risk of subsequent relapse at any time. Complete remission requires normalisation or stabilisation of any underlying pathology in addition to symptomatic remission. Remission is possible as part of the natural history of asthma, and the prevalence of remission in the adult asthma population varies between 2% and 52%. The factors associated with remission include mild asthma, better lung function, better asthma control, younger age, early-onset asthma, shorter duration of asthma, milder bronchial hyperresponsiveness, fewer comorbidities and smoking cessation or never smoking. Although previous studies have not targeted treatment-induced remission, there is some evidence to show that the current long-term add-on therapies such as biologics and azithromycin can achieve some criteria for asthma remission on treatment, at least in a subgroup of patients. However, more research is required. Long-term remission could be included as a therapeutic goal in studies of asthma treatments. European Respiratory Society 2022-11-03 /pmc/articles/PMC9630609/ /pubmed/35361633 http://dx.doi.org/10.1183/13993003.02583-2021 Text en Copyright ©The authors 2022. https://creativecommons.org/licenses/by-nc/4.0/This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org (mailto:permissions@ersnet.org)
spellingShingle Series
Thomas, Dennis
McDonald, Vanessa M.
Pavord, Ian D.
Gibson, Peter G.
Asthma remission: what is it and how can it be achieved?
title Asthma remission: what is it and how can it be achieved?
title_full Asthma remission: what is it and how can it be achieved?
title_fullStr Asthma remission: what is it and how can it be achieved?
title_full_unstemmed Asthma remission: what is it and how can it be achieved?
title_short Asthma remission: what is it and how can it be achieved?
title_sort asthma remission: what is it and how can it be achieved?
topic Series
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9630609/
https://www.ncbi.nlm.nih.gov/pubmed/35361633
http://dx.doi.org/10.1183/13993003.02583-2021
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