A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Burden of asthma by severity and exacerbation frequency among adult patients naive to biologic asthma therapy: A Finnish cohort study
Tekijät: Kankaanranta, Hannu; Viinanen, Arja; Klåvus, Anton; Lassenius, Mariann I.; Olsen, Helga Haugom; Nieminen, Kaisa; Lyly, Annina; Kauppi, Paula; Lehtimäki, Lauri
Kustantaja: Elsevier BV
Julkaisuvuosi: 2025
Journal: Journal of Allergy and Clinical Immunology: Global
Tietokannassa oleva lehden nimi: Journal of Allergy and Clinical Immunology: Global
Artikkelin numero: 100453
Vuosikerta: 4
ISSN: 2772-8293
eISSN: 2772-8293
DOI: https://doi.org/10.1016/j.jacig.2025.100453
Verkko-osoite: https://doi.org/10.1016/j.jacig.2025.100453
Rinnakkaistallenteen osoite: https://research.utu.fi/converis/portal/detail/Publication/491857876
Background
Understanding the disease burden and characteristics of asthmatic patients with frequent exacerbations is important for optimal disease management and outcomes. Asthma, and especially severe uncontrolled asthma, associates with an increased disease burden, but the comparison across asthma severity and exacerbation frequency is largely missing.
Objective
We sought to assess the association of asthma severity and exacerbation frequency with medication use, mortality, sick leaves, disability pensions, health care contacts, and comorbidities among Finnish patients with asthma.
Methods
National longitudinal retrospective data on adult patients naive to biologic asthma therapy were used to match patients on the basis of age, sex, and region across 4 subgroups (5525 patients in each) of nonsevere or severe asthma with infrequent or frequent exacerbations. The clinical characteristics, mortality rates, and morbidity across the subgroups were analyzed.
Results
Exacerbation frequency associated with an increased disease burden regardless of asthma severity. Comorbidities, health care contacts, sick leaves, and disability pensions cumulated in patients with frequent exacerbations, peaking with severe asthma. In patients with severe asthma and frequent exacerbations, the all-cause mortality rate ratio was 1.9-fold (P < .001) versus patients with nonsevere asthma and infrequent exacerbations. Patients with frequent exacerbations were also exposed to high cumulative corticosteroid doses.
Conclusions
Despite improved outcomes in asthma over the past decades, a substantial proportion of patients experience frequent exacerbations. These patients are multimorbid and at increased risk of mortality. Exacerbation frequency, rather than asthma severity, seems to be the main factor associated with an increased disease burden. Clinical awareness should be raised to improve the management and outcomes for these patients.
Ladattava julkaisu This is an electronic reprint of the original article. |  |
Julkaisussa olevat rahoitustiedot:
Funding for the conduct of this study was received by AstraZeneca.
Disclosure of potential conflict of interest: A. Viinanen, L. Lehtimäki, P. Kauppi, and H. Kankaanranta have received scientific committee consultancy fees from AstraZeneca for the conduct of the study. A. Viinanen reports fees for consultation or lectures from Airsonett, AstraZeneca, Boehringer Ingelheim, Chiesi, and GlaxoSmithKline. L. Lehtimäki reports fees for consultations, lectures, or clinical trials from ALK, AstraZeneca, Berlin Chemie, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Menarini, Mundipharma, Novartis, Orion, and Sanofi. P. Kauppi reports lecturing fees for Sanofi and research fees from Theravance, outside the submitted work; and is the Head of the Finnish Respiratory Society. H. Kankaanranta reports fees for consultations or lectures from AstraZeneca, Boehringer Ingelheim, Chiesi, Covis Pharma, GlaxoSmithKline, Merck Sharp & Dohme (MSD), Novartis, Orion Pharma, and Sanofi-Genzyme, outside the submitted work; is an asthma and allergy research professor funded by the Hermann Krefting Foundation; and his work is supported by ALF agreement (grant from the Swedish state under the agreement between the Swedish government and the county councils), the Swedish Research Council, the Asthma and Allergy Research Foundation (Sweden), the Tampere Tuberculosis Foundation (Tampere, Finland), and The Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital (Tampere, Finland). The employer of A. Klåvus and M. I. Lassenius, Medaffcon Oy, has received funding for the conduct of the study. A. Lyly is currently employed at Helsinki University Hospital and conducted this research when employed at AstraZeneca. H. H. Olsen and K. Nieminen are employees of AstraZeneca and may have stock ownership and/or stock options or interests in the company.
We thank Sophi Løge for valuable scientific input during the study and Juhani Aakko for statistical analysis support
