Prognosis of new-onset asthma diagnosed at adult age

Tuomisto, Leena E.; Ilmarinen, Pinja; Kankaanranta, Hannu

doi:10.1016/j.rmed.2015.05.001

Cited by 30 publications

(28 citation statements)

References 47 publications

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“…The use of two different kinds of spirometers, one with a turbine (MicroLoop) at baseline and one with ultra-sound transit time measurement (ndd EasyOne) at follow up may have affected the lung function data although calibration check was performed daily on both spirometers to minimise this bias. Furthermore, definitions of the age limit between early- and late-onset asthma vary widely in the literature [6,8,24]. However, the applied criteria for asthma and COPD are in line with recent research [18].…”

Section: Discussionmentioning

confidence: 89%

“…Analyses using pre-BD values showed larger decline per year, but did not influence on the role of the other determinants in the multivariate analyses. Previous studies have suggested accelerated lung function declines in asthma [28,29] and in a review of adult-onset asthma decline in FEV₁ varied between 25 and 95 ml per year [6]. Still, recent studies have found decline in FEV₁ in asthmatics of 25.3 [18] and 25.6 ml [30] per year, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of remission of asthma in adults has been reported in the range from 5 to 40%, and usually limited to individuals with mild disease [10,35,36]. However, remission rates can be difficult to compare since there is no golden standard to define remission [6]. …”

Section: Discussionmentioning

confidence: 99%

“…Common features include fluctuating respiratory symptoms associated with variable airflow limitation and bronchial hyperresponsiveness (BHR) due to inflammation of the airways. The age of asthma onset is an important factor for dividing the phenotypes and a major determinant of the prognosis [3–5], but the prognosis for adult-onset asthma is only sparsely documented [6]. In a prospective study of individuals with adult-onset asthma higher age, higher body mass index (BMI) and low lung function were associated with greater asthma severity, while non-sensitisation and a normal lung function were predictors for remission [7].…”

Section: Introductionmentioning

confidence: 99%

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Determinants of persistent asthma in young adults

Traulsen

Halling

Bælum

et al. 2018

European Clinical Respiratory Journal

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Objective: The aim of the study was to evaluate determinants for the prognosis of asthma in a population-based cohort of young adults.Design: The study was a nine-year clinical follow up of 239 asthmatic subjects from an enriched population-based sample of 1,191 young adults, aged 20–44 years, who participated in an interviewer-administered questionnaire and clinical examination at baseline in 2003–2006. From the interview, an asthma score was generated as the simple sum of affirmative answers to five main asthma-like symptoms in order to analyse symptoms of asthma as a continuum. The clinical examination comprised spirometry, bronchial challenge or bronchodilation, and skin prick test.Results: Among the 239 individuals with asthma at baseline 164 (69%) had persistent asthma at follow up, while 68 (28%) achieved remission of asthma and seven (3%) were diagnosed with COPD solely. Determinants for persistent asthma were use of medication for breathing within the last 12 months: Short-acting beta-adrenoceptor agonists (SABA) only (OR 3.39; 95%CI: 1.47–7.82) and inhaled corticosteroids (ICS) and/or long-acting beta-adrenoceptor agonists (LABA) (8.95; 3.87–20.69). Stratified by age of onset determinants for persistence in individuals with early-onset asthma (age less than 16 years) were FEV₁ below predicted (7.12; 1.61–31.50), asthma score at baseline (2.06; 1.15–3.68) and use of ICS and/or LABA within 12 months (9.87; 1.95–49.98). In individuals with late-onset asthma the determinant was use of ICS and/or LABA within 12 months (6.84; 2.09–22.37).Conclusions: Pulmonary function below predicted, severity of disease expressed by asthma score and use of ICS and/or LABA were all determinants for persistent early-onset asthma, whereas only use of ICS and/or LABA was a determinant in late-onset asthma. A high asthma score indicated insufficient disease control in a substantial proportion of these young adults.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Determinants of persistent asthma in young adults

Traulsen

Halling

Bælum

et al. 2018

European Clinical Respiratory Journal

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“…In addition, the good prognosis strengthens the view. 36 A corresponding adult-onset group was recognized in the COREA study 6 and many studies have recognized childhood-onset atopic asthma. 5,7,10 A rather high annual lung function decline was seen after the reach of maximum point but this may be related to lung capacity because higher reversibility and higher maximal FEV 1 enable higher decline in lung function.…”

Section: Discussionmentioning

confidence: 98%

Cluster analysis on longitudinal data of patients with adult-onset asthma

Ilmarinen¹,

Tuomisto²,

Niemelä

et al. 2016

5.1 Airway Pharmacology and Treatment

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What is already known about this topic? Many phenotypes of asthma have been identified in previous cluster analyses, mostly on the basis of cross-sectional data with limited inclusion of patients. Some studies have provided short-term 1-to 3-year prognosis for the phenotypes.What does this article add to our knowledge? This is the first study that reports long-term 12-year prognosis for clusters of adult-onset asthma starting from diagnosis. We report different disease prognoses for smoking, obesity-related, female, atopic, and nonrhinitic asthma.How does this study impact current management guidelines? Information on long-term outcome of asthma can be used to inform and motivate patients. We show the poorest outcome and the most unmet needs in the therapy of smoking and obesity-related asthma, suggesting need for special guidance.BACKGROUND: Previous cluster analyses on asthma are based on cross-sectional data. OBJECTIVE: To identify phenotypes of adult-onset asthma by using data from baseline (diagnostic) and 12-year follow-up visits. METHODS: The Seinäjoki Adult Asthma Study is a 12-year follow-up study of patients with new-onset adult asthma. K-means cluster analysis was performed by using variables from baseline and follow-up visits on 171 patients to identify phenotypes. RESULTS: Five clusters were identified. Patients in cluster 1 (n [ 38) were predominantly nonatopic males with moderate smoking history at baseline. At follow-up, 40% of these patients had developed persistent obstruction but the number of patients with uncontrolled asthma (5%) and rhinitis (10%) was the lowest. Cluster 2 (n [ 19) was characterized by older men with

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