Volume 120, Issue 4 , Pages 863-869, October 2007
Childhood allergic rhinitis predicts asthma incidence and persistence to middle age: A longitudinal study
Background
The association between allergic rhinitis and asthma is well documented, but the temporal sequence of this association has not been closely examined.
Objective
We sought to assess the associations between childhood allergic rhinitis and (1) asthma incidence from preadolescence to middle age and (2) asthma persistence to middle age.
Methods
Data were gathered from the 1968, 1974, and 2004 surveys of the Tasmanian Asthma Study. Cox regression was used to examine the association between childhood allergic rhinitis and asthma incidence in preadolescence, adolescence, and adult life. Binomial regression was used to examine the association between childhood allergic rhinitis and asthma beginning before the age of 7 years and persisting at age 44 years.
Results
Childhood allergic rhinitis was associated with a significant 2- to 7-fold increased risk of incident asthma in preadolescence, adolescence, or adult life. Childhood allergic rhinitis was associated with a 3-fold increased risk of childhood asthma persisting compared with remitting by middle age.
Conclusions
Childhood allergic rhinitis increased the likelihood of new-onset asthma after childhood and the likelihood of having persisting asthma from childhood into middle age.
Clinical implications
Asthma burden in later life might be reduced by more aggressive treatment of allergic rhinitis in early life.
Key words: Childhood allergic rhinitis, incident asthma, persisting asthma, effect modification
Abbreviations used: ARR, Adjusted relative risk, TAS, Tasmanian Asthma Study
The Tasmanian Asthma Study is supported by grants from the National Health and Medical Research Council of Australia, the Asthma Foundations of Victoria and Tasmania, the Clifford Craig Medical Research Trust, and the Royal Hobart Hospital Research Foundation. John Burgess is supported by a Research Scholarship from the University of Melbourne. Graham Byrnes, Melanie Matheson, John Hopper, and Shyamali Dharmage are supported by the National Health and Medical Research Council of Australia.
Disclosure of potential conflict of interest: M. J. Abramson has consulting arrangements with the Australian Asthma Study, which was sponsored by GlaxoSmithKline; received an honorarium from Boehringer Ingelheim for a presentation at Airways 2006; and received travel support from AstraZeneca. The rest of the authors have declared that they have no conflict of interest.
PII: S0091-6749(07)01392-9
doi:10.1016/j.jaci.2007.07.020
© 2007 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
Volume 120, Issue 4 , Pages 863-869, October 2007
