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 Bülow, Anna; Hansen, Susanne; Sandin, Patrik; Ernstsson, Olivia; Janson, Christer; Lehtimäki, Lauri; Kankaanranta, Hannu; Ulrik, Charlotte; Aarli, Bernt Bøgvald; Geale, Kirk; Tang, Sheila Tuyet; Wolf, Maija; Backer, Vibeke; Hilberg, Ole; Altraja, Alan; Backman, Helena; Lúdvíksdóttir, Dóra; Björnsdóttir, Unnur Steina; Kauppi, Paula; Sandström, Thomas; Sverrild, Asger; Yasinska, Valentyna; Kilpeläinen, Maritta; Dahlén, Barbro; Viinanen, Arja; Bjermer, Leif; Bossios, Apostolos; Porsbjerg, Celeste.
In: European Respiratory Journal, Vol. 62, No. 3, 2202474, 2023.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Severe asthma trajectories in adults
T2 - findings from the NORDSTAR cohort
AU - von Bülow, Anna
AU - Hansen, Susanne
AU - Sandin, Patrik
AU - Ernstsson, Olivia
AU - Janson, Christer
AU - Lehtimäki, Lauri
AU - Kankaanranta, Hannu
AU - Ulrik, Charlotte
AU - Aarli, Bernt Bøgvald
AU - Geale, Kirk
AU - Tang, Sheila Tuyet
AU - Wolf, Maija
AU - Backer, Vibeke
AU - Hilberg, Ole
AU - Altraja, Alan
AU - Backman, Helena
AU - Lúdvíksdóttir, Dóra
AU - Björnsdóttir, Unnur Steina
AU - Kauppi, Paula
AU - Sandström, Thomas
AU - Sverrild, Asger
AU - Yasinska, Valentyna
AU - Kilpeläinen, Maritta
AU - Dahlén, Barbro
AU - Viinanen, Arja
AU - Bjermer, Leif
AU - Bossios, Apostolos
AU - Porsbjerg, Celeste
N1 - Funding Information: Support statement: This study is presented on behalf of the NORDSTAR study group. NORDSTAR is a pan-Nordic multiparty research collaboration platform governed by the Nordic Severe Asthma Network (NSAN). Data management and analyses are conducted by Quantify Research (Stockholm, Sweden). NORDSTAR is financially supported by Novartis and Sanofi and Regeneron Pharmaceuticals. Funding information for this article has been deposited with the Crossref Funder Registry. Publisher Copyright: Copyright ©The authors 2023.
PY - 2023
Y1 - 2023
N2 - 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.
AB - 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.
U2 - 10.1183/13993003.02474-2022
DO - 10.1183/13993003.02474-2022
M3 - Journal article
C2 - 37620041
AN - SCOPUS:85170581634
VL - 62
JO - The European respiratory journal
JF - The European respiratory journal
SN - 0903-1936
IS - 3
M1 - 2202474
ER -
ID: 397242112