作者@article {Longo2001897 ={隆戈,克里斯蒂娜and Blais, Lucie and Brownell, Marni and Quail, Jacqueline M. and Sadatsafavi, Mohsen and Forget, Am{\'e}lie and Turcot, Marc-Andr{\'e} and Nie, Yao and Li, Wenbin and Tavakoli, Hamid and Tan, Qier and Fan, Yuxin and Platt, Robert W. and Ducharme, Francine M.}, title = {Association between asthma control trajectories in preschoolers and disease remission}, volume = {57}, number = {5}, elocation-id = {2001897}, year = {2021}, doi = {10.1183/13993003.01897-2020}, publisher = {European Respiratory Society}, abstract = {Introduction Early disease morbidity has been associated with asthma persistence in wheezing preschoolers; however, whether asthma control trajectories shortly after diagnosis could influence remission is unknown. We examined the association between asthma control trajectories 2 years post-diagnosis in preschoolers and subsequent disease remission.Methods We conducted a multicentre population-based retrospective cohort study consisting of 48 687 children with asthma diagnosed before 5 years old and born between 1990 and 2013 in four Canadian provinces who had prolonged disease activity post-diagnosis. Prolonged disease activity was defined as one or more medical visits or medications for asthma every 6-month period for at least four of the six periods post-diagnosis. Follow-up began at 3 years post-diagnosis (at cohort entry). Remission was defined as 2 consecutive years without drug claims or medical visits for asthma or asthma-like conditions following cohort entry. Asthma control trajectories, ascertained over four 6-month periods following diagnosis using a validated index, were classified as: {\textquotedblleft}controlled throughout{\textquotedblright}, {\textquotedblleft}improving control{\textquotedblright}, {\textquotedblleft}worsening control{\textquotedblright}, {\textquotedblleft}out of control throughout{\textquotedblright} and {\textquotedblleft}fluctuating control{\textquotedblright}. Adjusted Cox models estimated associations between asthma control trajectories and time to remission. A random effects meta-analysis summarised province-specific hazard ratios (HRs).Results The pooled remission rate was 8.91 (95\% CI 8.80{\textendash}9.02) per 100 person-years. Compared with children controlled throughout, poorer asthma control was associated with incrementally lower hazard ratios of remission in four other trajectories: improving control (HR 0.89, 95\% CI 0.82{\textendash}0.96), fluctuating control (HR 0.78, 95\% CI 0.71{\textendash}0.85), worsening control (HR 0.68, 95\% CI 0.62{\textendash}0.75) and out of control throughout (HR 0.52, 95\% CI 0.45{\textendash}0.59).Conclusions Asthma control trajectories 2 years following a diagnosis in preschoolers were associated with remission, highlighting the clinical relevance of documenting control trajectories in early life.In this multicentre population-based cohort study, the worse the asthma control trajectory shortly following diagnosis in preschoolers, the lower the likelihood of remission https://bit.ly/3lHVsNf}, issn = {0903-1936}, URL = {//www.qdcxjkg.com/content/57/5/2001897}, eprint = {//www.qdcxjkg.com/content/57/5/2001897.full.pdf}, journal = {European Respiratory Journal} }