Journal of Asthma and Allergy (Oct 2022)

Determinants of Severe Asthma – A Long-Term Cohort Study in Northern Sweden

  • Backman H,
  • Stridsman C,
  • Hedman L,
  • Rönnebjerg L,
  • Nwaru BI,
  • Sandström T,
  • Kankaanranta H,
  • Lindberg A,
  • Rönmark E

Journal volume & issue
Vol. Volume 15
pp. 1429 – 1439

Abstract

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Helena Backman,1 Caroline Stridsman,2 Linnea Hedman,1 Lina Rönnebjerg,3 Bright I Nwaru,3,4 Thomas Sandström,2 Hannu Kankaanranta,3,5,6 Anne Lindberg,2 Eva Rönmark1 1Department of Public Health and Clinical Medicine, Section of Sustainable Health/the OLIN unit, Umeå University, Umeå, Sweden; 2Department of Public Health and Clinical Medicine, Section of Medicine/the OLIN unit, Umeå University, Umeå, Sweden; 3Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; 4Wallenberg Centre for Molecular and Translational Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; 5Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland; 6Faculty of Medicine and Health Technology, Tampere University, Tampere, FinlandCorrespondence: Helena Backman, Department of Public Health and Clinical Medicine, Section of Sustainable Health/the OLIN Unit, Umeå University, Umeå, Sweden, Email [email protected]: Risk factors for severe asthma are not well described. The aim was to identify clinical characteristics and risk factors at study entry that are associated with severe asthma at follow-up in a long-term prospective population-based cohort study of adults with asthma.Methods: Between 1986 and 2001, 2055 adults with asthma were identified by clinical examinations of population-based samples in northern Sweden. During 2012– 2014, n = 1006 (71% of invited) were still alive, residing in the study area and participated in a follow-up, of which 40 were identified as having severe asthma according to ERS/ATS, 131 according to GINA, while 875 had other asthma. The mean follow-up time was 18.7 years.Results: Obesity at study entry and adult-onset asthma were associated with severe asthma at follow-up. While severe asthma was more common in those with adult-onset asthma in both men and women, the association with obesity was observed in women only. Sensitization to mites and moulds, but not to other allergens, as well as NSAID-related respiratory symptoms was more common in severe asthma than in other asthma. Participants with severe asthma at follow-up had lower FEV1, more pronounced FEV1 reversibility, and more wheeze, dyspnea and nighttime awakenings already at study entry than those with other asthma.Conclusion: Adult-onset asthma is an important risk factor for development of severe asthma in adults, and obesity increased the risk among women. The high burden of respiratory symptoms already at study entry also indicate long-term associations with development of severe asthma.Keywords: epidemiology, phenotype, precision medicine, prognosis, risk factors

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