Severe asthma trajectories in adults: findings from the NORDSTAR cohort

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Severe asthma trajectories in adults: findings from the NORDSTAR cohort

von Büllow, A. (författare): Respiratory Research Unit, Department of Respiratory Medicine and Infectious Diseases, Bispebjerg Hospital, Copenhagen, Denmark,Department of Pulmonology, University of Tartu and Lung Clinic, Tartu University Hospital, Tartu, Estonia,Bispebjerg Hosp, Dept Resp Med, Resp Res Unit, Copenhagen, Denmark.,Tartu Univ, Tartu Univ Hosp, Lung Clin, Riia 167, EE-50411 Tartu, Estonia.

Hansen, S. (författare): Respiratory Research Unit, Department of Respiratory Medicine and Infectious Diseases, Bispebjerg Hospital, Copenhagen, Denmark; Centre for Clinical Research and Prevention, Frederiksberg Hospital, Copenhagen, Denmark,Bispebjerg Hosp, Dept Resp Med, Resp Res Unit, Copenhagen, Denmark.;Frederiksberg Univ Hosp, Ctr Clin Res & Prevent, Copenhagen, Denmark.

Sandin, P. (författare): Quantify Research, Stockholm, Sweden,Quantify Res, Stockholm, Sweden.

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Ernstsson, O. (författare): Karolinska Institutet

Janson, Christer (författare): Uppsala universitet,Lung- allergi- och sömnforskning

Lehtimaeki, L. (författare): Allergy Centre, Tampere University Hospital, Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland,Tampere Univ Hosp, Allergy Ctr, Tampere, Finland.;Tampere Univ, Fac Med & Hlth Technol, Tampere, Finland.

Kankaanranta, Hannu, 1967 (författare): Gothenburg University,Göteborgs universitet,Krefting Research Centre,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland,Tampere Univ, Fac Med & Hlth Technol, Tampere, Finland.;Univ Gothenburg, Krefting Res Ctr, Inst Med, Dept Internal Med & Clin Nutr,Sahlgrenska Acad, Gothenburg, Sweden.;Seinajoki Cent Hosp, Dept Resp Med, Seinajoki, Finland.

Ulrik, C. (författare): Respiratory Research Unit Hvidovre, Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Hvidovre, Denmark,Copenhagen Univ Hosp Hvidovre, Dept Resp Med, Resp Res Unit Hvidovre, Hvidovre, Denmark.

Aarli, B. B. (författare): Karolinska Institutet

Geale, Kirk (författare): Umeå universitet,Institutionen för folkhälsa och klinisk medicin,Quantify Research, Stockholm, Sweden,Quantify Res, Stockholm, Sweden.;Umeå Univ, Dept Publ Hlth & Clin Med, Umeå, Sweden.

Sandström, Thomas, 1957- (författare): Umeå universitet,Institutionen för folkhälsa och klinisk medicin

Wolf, M. (författare): Novartis Finland, Espoo, Finland.

Backer, V. (författare): Department of Otorhinolaryngology, Head and Neck Surgery, Audiology, Rigshospitalet, Copenhagen, Denmark,Rigshospitalet, Dept Otorhinolaryngol Head & Neck Surg & Audiol, Copenhagen, Denmark.

Hilberg, O. (författare): Department of Medicine, Vejle Hospital, Vejle, Denmark,Vejle Hosp, Dept Med, Vejle, Denmark.

Altraja, A. (författare)

Backman, Helena (författare): Umeå universitet,Avdelningen för hållbar hälsa,Umeg Univ, Dept Publ Hlth & Clin Med, Sect Sustainable Hlth, Umeå, Sweden.

Lúdvíksdóttir, D. (författare): Department of Respiratory Medicine, Landspitali University Hospital, University of Iceland, Reykjavik, Iceland,Landspitali Univ Hosp Iceland, Dept Resp Med, Reykjavik, Iceland.

Björnsdóttir, U. S. (författare): Department of Respiratory Medicine and Allergy, Landspitali University Hospital, Reykjavik, Iceland,Landspitali Univ Hosp, Dept Resp Med & Allergy, Reykjavik, Iceland.

Kauppi, P. (författare): Heart and Lung Center, Department of Pulmonary Diseases, Helsinki University Hospital and University of Helsinki, Helsinki, Finland,Helsinki Univ Hosp, Heart & Lung Ctr, Dept Pulm Dis, Helsinki, Finland.;Univ Helsinki, Helsinki, Finland.

Sandström, T. (författare)

Sverrild, A. (författare): Respiratory Research Unit, Department of Respiratory Medicine and Infectious Diseases, Bispebjerg Hospital, Copenhagen, Denmark,Bispebjerg Hosp, Dept Resp Med, Resp Res Unit, Copenhagen, Denmark.

Yasinska, V. (författare): Karolinska Institutet

Kilpeläinen, M. (författare): Division of Medicine, Department of Pulmonary Diseases, Turku University Hospital, Turku, Finland; Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland,Turku Univ Hosp, Dept Pulm Dis, Div Med, Turku, Finland.;Univ Turku, Dept Pulm Dis & Clin Allergol, Turku, Finland.

Dahlen, B. (författare): Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Huddinge, Sweden; Department of Medicine, Karolinska Institutet, Stockholm, Huddinge, Sweden,Karolinska Univ Hosp Huddinge, Dept Resp Med & Allergy, Stockholm, Sweden.;Karolinska Inst, Dept Med Huddinge, Stockholm, Sweden.

Viinanen, A. (författare): Division of Medicine, Department of Pulmonary Diseases, Turku University Hospital, Turku, Finland; Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland,Turku Univ Hosp, Dept Pulm Dis, Div Med, Turku, Finland.;Univ Turku, Dept Pulm Dis & Clin Allergol, Turku, Finland.

Bjermer, L. (författare): Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund, Sweden,Skane Univ Hosp, Dept Resp Med & Allergol, Lund, Sweden.

Bossios, A. (författare): Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Huddinge, Sweden; Department of Medicine, Karolinska Institutet, Stockholm, Huddinge, Sweden; Division of Lung and Airway Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden,Karolinska Univ Hosp Huddinge, Dept Resp Med & Allergy, Stockholm, Sweden.;Karolinska Inst, Dept Med Huddinge, Stockholm, Sweden.;Karolinska Inst, Inst Environm Med, Div Lung & Airway Res, Stockholm, Sweden.

Porsbjerg, C. (författare): Respiratory Research Unit, Department of Respiratory Medicine and Infectious Diseases, Bispebjerg Hospital, Copenhagen, Denmark,Bispebjerg Hosp, Dept Resp Med, Resp Res Unit, Copenhagen, Denmark.

Tang, Sheila Tuyet (författare): Sanofi, Copenhagen, Denmark.

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(creator_code:org_t)

European Respiratory Society, 2023
2023
Engelska.
Ingår i: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 62:3

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Background There is limited evidence on the pathways leading to severe asthma and we are presently unable to effectively predict the progression of the disease. We aimed to describe the longitudinal trajectories leading to severe asthma and to describe clinical events preceding disease progression in a nationwide population of patients with severe asthma.Methods We conducted an observational study based on Swedish data from the NORdic Dataset for aSThmA Research (NORDSTAR) research collaboration platform. We identified adult patients with severe asthma in 2018 according to the European Respiratory Society/American Thoracic Society definition and used latent class analysis to identify trajectories of asthma severity over a 10-year retrospective period from 2018.Results Among 169 128 asthma patients, we identified 4543 severe asthma patients. We identified four trajectories of severe asthma that were labelled as: trajectory 1 "consistently severe asthma" (n=389 (8.6%)), trajectory 2 "gradual onset severe asthma" (n=942 (20.7%)), trajectory 3 "intermittent severe asthma" (n=1685 (37.1%)) and trajectory 4 "sudden onset severe asthma" (n=1527 (33.6%)). "Consistently severe asthma" had a higher daily inhaled corticosteroid dose and more prevalent osteoporosis compared with the other trajectories. Patients with "gradual onset severe asthma" and "sudden onset severe asthma" developed type 2-related comorbidities concomitantly with development of severe asthma. In the latter group, this primarily occurred within 1-3 years preceding onset of severe asthma.Conclusions Four distinct trajectories of severe asthma were identified illustrating different patterns of progression of asthma severity. This may eventually enable the development of better preventive management strategies in severe asthma.

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Severe asthma trajectories in adults: findings from the NORDSTAR cohort

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