Helena Backman1, Sven-Arne Jansson1, Caroline Stridsman2, Berne Eriksson3,4, Linnea Hedman1, Britt-Marie Eklund1, Thomas Sandström5, Anne Lindberg5, Bo Lundbäck1,3, Eva Rönmark1. 1. Section of Sustainable Health, The OLIN Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. 2. Department of Health Sciences, Luleå University of Technology, Luleå, Sweden. 3. Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden. 4. Deparment of Internal Medicine, Central County Hospital of Halland, Halmstad, Sweden. 5. Section of Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Abstract
BACKGROUND: Severe asthma is a considerable challenge for patients, health-care professionals and society. Few studies have estimated the prevalence of severe asthma according to modern definitions of which none based on a population study. OBJECTIVE: To describe characteristics and estimate the prevalence of severe asthma in a large adult population-based asthma cohort followed for 10-28 years. METHODS: N = 1006 subjects with asthma participated in a follow-up during 2012-14, when 830 (mean age 59 years, 56% women) still had current asthma. Severe asthma was defined according to three internationally well-known criteria: the ATS workshop definition from 2000 used in the US Severe Asthma Research Programme (SARP), the 2014 ATS/ERS Task force definition and the GINA 2017. All subjects with severe asthma according to any of these criteria were undergoing respiratory specialist care and were also contacted by telephone to verify treatment adherence. RESULTS: The prevalence of severe asthma according to the three definitions was 3.6% (US SARP), 4.8% (ERS/ATS Taskforce), and 6.1% (GINA) among subjects with current asthma. Although all were using high ICS doses and other maintenance treatment, >90% did not have controlled asthma according to the asthma control test. Severe asthma was related to age >50 years, nasal polyposis, impaired lung function, sensitization to aspergillus, and tended to be more common in women. Further, neutrophils in blood significantly discriminated severe asthma from other asthma. CONCLUSIONS AND CLINICAL RELEVANCE: Severe asthma differed significantly from other asthma in terms of demographic, clinical and inflammatory characteristics, results suggesting possibilities for improved treatment regimens of severe asthma. The prevalence of severe asthma in this asthma cohort was 4%-6%, corresponding to approximately 0.5% of the general population.
BACKGROUND: Severe asthma is a considerable challenge for patients, health-care professionals and society. Few studies have estimated the prevalence of severe asthma according to modern definitions of which none based on a population study. OBJECTIVE: To describe characteristics and estimate the prevalence of severe asthma in a large adult population-based asthma cohort followed for 10-28 years. METHODS: N = 1006 subjects with asthma participated in a follow-up during 2012-14, when 830 (mean age 59 years, 56% women) still had current asthma. Severe asthma was defined according to three internationally well-known criteria: the ATS workshop definition from 2000 used in the US Severe Asthma Research Programme (SARP), the 2014 ATS/ERS Task force definition and the GINA 2017. All subjects with severe asthma according to any of these criteria were undergoing respiratory specialist care and were also contacted by telephone to verify treatment adherence. RESULTS: The prevalence of severe asthma according to the three definitions was 3.6% (US SARP), 4.8% (ERS/ATS Taskforce), and 6.1% (GINA) among subjects with current asthma. Although all were using high ICS doses and other maintenance treatment, >90% did not have controlled asthma according to the asthma control test. Severe asthma was related to age >50 years, nasal polyposis, impaired lung function, sensitization to aspergillus, and tended to be more common in women. Further, neutrophils in blood significantly discriminated severe asthma from other asthma. CONCLUSIONS AND CLINICAL RELEVANCE: Severe asthma differed significantly from other asthma in terms of demographic, clinical and inflammatory characteristics, results suggesting possibilities for improved treatment regimens of severe asthma. The prevalence of severe asthma in this asthma cohort was 4%-6%, corresponding to approximately 0.5% of the general population.
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Authors: Mi Ae Kim; Heung Woo Park; Byung Keun Kim; So Young Park; Ga Young Ban; Ji Hyang Lee; Jin An; Ji Su Shim; Youngsoo Lee; Ha Kyeong Won; Hwa Young Lee; Kyoung Hee Sohn; Sung Yoon Kang; So Young Park; Hyun Lee; Min Hye Kim; Jae Woo Kwon; Sun Young Yoon; Jae Hyun Lee; Chin Kook Rhee; Ji Yong Moon; Taehoon Lee; So Ri Kim; Jong Sook Park; Sang Heon Kim; Jae Won Jeong; Sang Hoon Kim; Young Il Koh; Yeon Mok Oh; An Soo Jang; Kwang Ha Yoo; You Sook Cho Journal: Allergy Asthma Immunol Res Date: 2021-05 Impact factor: 5.764
Authors: Helena Backman; Anne Lindberg; Linnea Hedman; Caroline Stridsman; Sven-Arne Jansson; Thomas Sandström; Bo Lundbäck; Eva Rönmark Journal: World Allergy Organ J Date: 2020-03-17 Impact factor: 4.084
Authors: Byung Keun Kim; So Young Park; Ga Young Ban; Mi Ae Kim; Ji Hyang Lee; Jin An; Ji Su Shim; Youngsoo Lee; Ha Kyeong Won; Hwa Young Lee; Kyoung Hee Sohn; Sung Yoon Kang; So Young Park; Hyun Lee; Min Hye Kim; Jae Woo Kwon; Sun Young Yoon; Jae Hyun Lee; Chin Kook Rhee; Ji Yong Moon; Taehoon Lee; So Ri Kim; Jong Sook Park; Sang Heon Kim; Heung Woo Park; Jae Won Jeong; Sang Hoon Kim; Young Il Koh; Yeon Mok Oh; An Soo Jang; Kwang Ha Yoo; You Sook Cho Journal: Allergy Asthma Immunol Res Date: 2020-11 Impact factor: 5.764