Iida Vähätalo1, Pinja Ilmarinen2, Leena E Tuomisto3, Onni Niemelä4, Hannu Kankaanranta5. 1. Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland. Electronic address: iida.vahatalo@epshp.fi. 2. Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland. Electronic address: pinja.ilmarinen@epshp.fi. 3. Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland. Electronic address: leena.tuomisto@epshp.fi. 4. Department of Laboratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland; University of Tampere, Tampere, Finland. Electronic address: onni.niemela@epshp.fi. 5. Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland; Department of Respiratory Medicine, University of Tampere, Tampere, Finland. Electronic address: hannu.kankaanranta@epshp.fi.
Abstract
BACKGROUND: Prescribed inhaled corticosteroid (ICS) doses in asthma have been studied in cross-sectional settings whereas long-term follow-up studies have not been carried out. OBJECTIVE: To evaluate prescribed medication longitudinally by calculating cumulative ICS doses and dose changes in a cohort of new-onset adult asthma during 12 years and in different groups of asthma control. METHODS: A total of 203 patients were followed for 12 years as part of Seinäjoki Adult Asthma Study (SAAS). All asthma-related visits and prescribed medication over the study period were collected from medical records. RESULTS: Total cumulative ICS dose for the 12-year follow-up period was 3.4g (±SEM 0.1) per patient. Both respiratory specialists and GPs prescribed step-ups and step-downs in ICS treatment and in total 649 dose changes were noted during the follow-up (median 3(1-5) per patient). Patients with uncontrolled asthma received higher ICS doses throughout the follow-up period, and therefore, cumulative 12-year ICS dose (3.8g ± SEM 0.2) in this group was higher than that in those with partially controlled (3.4g ± SEM 0.2) or controlled disease (2.9g ± SEM 0.2) (p = 0.0001). Patients with uncontrolled asthma were also prescribed a higher number of ICS dose changes than patients with controlled disease. CONCLUSION: Despite frequent dose changes and high ICS doses during the 12-year follow-up, the level of asthma control remained poor in patients with uncontrolled asthma. This suggests that high ICS doses may not be effective enough for management of disease in patients with uncontrolled adult-onset asthma and novel targeted treatments are required.
BACKGROUND: Prescribed inhaled corticosteroid (ICS) doses in asthma have been studied in cross-sectional settings whereas long-term follow-up studies have not been carried out. OBJECTIVE: To evaluate prescribed medication longitudinally by calculating cumulative ICS doses and dose changes in a cohort of new-onset adult asthma during 12 years and in different groups of asthma control. METHODS: A total of 203 patients were followed for 12 years as part of Seinäjoki Adult Asthma Study (SAAS). All asthma-related visits and prescribed medication over the study period were collected from medical records. RESULTS: Total cumulative ICS dose for the 12-year follow-up period was 3.4g (±SEM 0.1) per patient. Both respiratory specialists and GPs prescribed step-ups and step-downs in ICS treatment and in total 649 dose changes were noted during the follow-up (median 3(1-5) per patient). Patients with uncontrolled asthma received higher ICS doses throughout the follow-up period, and therefore, cumulative 12-year ICS dose (3.8g ± SEM 0.2) in this group was higher than that in those with partially controlled (3.4g ± SEM 0.2) or controlled disease (2.9g ± SEM 0.2) (p = 0.0001). Patients with uncontrolled asthma were also prescribed a higher number of ICS dose changes than patients with controlled disease. CONCLUSION: Despite frequent dose changes and high ICS doses during the 12-year follow-up, the level of asthma control remained poor in patients with uncontrolled asthma. This suggests that high ICS doses may not be effective enough for management of disease in patients with uncontrolled adult-onset asthma and novel targeted treatments are required.
Authors: Jaana Takala; Iida Vähätalo; Leena E Tuomisto; Onni Niemelä; Pinja Ilmarinen; Hannu Kankaanranta Journal: NPJ Prim Care Respir Med Date: 2022-10-21 Impact factor: 3.289
Authors: Pinja Ilmarinen; Hind Juboori; Leena E Tuomisto; Onni Niemelä; Harri Sintonen; Hannu Kankaanranta Journal: Sci Rep Date: 2019-11-06 Impact factor: 4.379
Authors: Carolin Veit; Ronald Herrera; Gudrun Weinmayr; Jon Genuneit; Doris Windstetter; Christian Vogelberg; Erika von Mutius; Dennis Nowak; Katja Radon; Jessica Gerlich; Tobias Weinmann Journal: BMC Med Res Methodol Date: 2020-12-16 Impact factor: 4.615
Authors: Iida Vähätalo; Pinja Ilmarinen; Leena E Tuomisto; Minna Tommola; Onni Niemelä; Lauri Lehtimäki; Pentti Nieminen; Hannu Kankaanranta Journal: ERJ Open Res Date: 2020-03-23
Authors: Jaana Takala; Pinja Ilmarinen; Leena E Tuomisto; Iida Vähätalo; Onni Niemelä; Hannu Kankaanranta Journal: NPJ Prim Care Respir Med Date: 2020-03-20 Impact factor: 2.871