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We thank Ayubi and Safiri1Ayubi E. Safiri S. Comments on clinical predictors of remission and persistence of adult-onset asthma.J Allergy Clin Immunol. 2018; 141: 458-459Abstract Full Text Full Text PDF Scopus (2) Google Scholar for their commentary on our recently published article “Clinical predictors of remission and persistence of adult-onset asthma.”2Westerhof G.A. Coumou H. de Nijs S.B. Weersink E.J. Bel E.H. Clinical predictors of remission and persistence of adult-onset asthma.J Allergy Clin Immunol. 2017; ([Epub ahead of print])Abstract Full Text Full Text PDF PubMed Scopus (43) Google Scholar In this study, we found that moderate to severe bronchial hyperresponsiveness and nasal polyps were independent predictors of asthma persistence.2Westerhof G.A. Coumou H. de Nijs S.B. Weersink E.J. Bel E.H. Clinical predictors of remission and persistence of adult-onset asthma.J Allergy Clin Immunol. 2017; ([Epub ahead of print])Abstract Full Text Full Text PDF PubMed Scopus (43) Google Scholar At first, Ayubi and Safiri raise concern about the lack of predictive performance testing, which might lead to overfitting of the final model in our study.2Westerhof G.A. Coumou H. de Nijs S.B. Weersink E.J. Bel E.H. Clinical predictors of remission and persistence of adult-onset asthma.J Allergy Clin Immunol. 2017; ([Epub ahead of print])Abstract Full Text Full Text PDF PubMed Scopus (43) Google Scholar However, it was not the aim of our study to test the predictive performance of a prediction model. The main goal of our study was to identify baseline predictors of adult-onset asthma remission and persistence after 5-year follow-up. Therefore, we used logistic regression analysis to identify baseline factors associated with the outcomes persistence or remission. After selection, bronchial hyperresponsiveness and nasal polyps appeared to be the only independently associated factors with asthma outcome. To offer a clinically useful interpretation of this finding, we constructed a prediction formula that can be used to estimate the chance of asthma remission for a patient with newly diagnosed asthma. This model might indeed be more optimistic than a validated model, but this does not challenge the relevance of nasal polyps and bronchial hyperresponsiveness in determining asthma outcome. Second, Ayubi and Safiri1Ayubi E. Safiri S. Comments on clinical predictors of remission and persistence of adult-onset asthma.J Allergy Clin Immunol. 2018; 141: 458-459Abstract Full Text Full Text PDF Scopus (2) Google Scholar comment on the use of fixed confounders instead of time-varying and time-modified confounders. In the logistic regression we used fixed baseline factors that were measured shortly after asthma diagnosis. Whether these factors change over time does not matter for the association between a baseline factor and the outcome after 5 years. However, we do think that the change in (confounding) variables might be of interest; therefore, in our futures analyses we will take longitudinal changes into account, for example, change in FEV1 or fluctuations of inflammatory markers. Comments on clinical predictors of remission and persistence of adult-onset asthmaJournal of Allergy and Clinical ImmunologyVol. 141Issue 1PreviewWe were interested to read the article by Westerhof et al1 published as an article in press in the Journal of Allergy and Clinical Immunology in April 2017. They tried to identify the significant predictors of asthma persistence and remission in adults with newly diagnosed, well-defined asthma. The results demonstrated that nasal polyps and airway hyperresponsiveness can be significant predictors of persistent asthma.1 Undoubtedly, an important study has been conducted but it seems that some methodological points should be noticed. Full-Text PDF