High prevalence of severe asthma in a large random population study
Abstract
Background The prevalence of asthma severity is not well described at a population level.Objective We sought to determine the prevalence of phenotypic signs of asthma severity among asthmatic patients in a general population and to describe risk factors for asthma severity.Methods We performed an epidemiologic study conducted between 2008 and 2012 (West Sweden Asthma Study). A postal questionnaire was sent to a random population (n = 30,000) in west Sweden, with 18,087 responses. A total of 2,006 subjects were carefully phenotyped. Only subjects with "active asthma" (symptoms or medication in the last year, n = 744) were analyzed in this study to determine the degree of severity of the disease within an asthma cohort. Phenotypes of severity were calculated based on (1) multiple symptoms during the day despite ongoing use of asthma medications, (2) FEV 1 of less than 70% of predicted value, (3) daily or almost daily use of rescue medications, (4) nighttime symptoms once a week or more, and (5) oral corticosteroid use/emergency department visits. Asthmatic patients were grouped as having nonsevere disease, 1 sign of severity, or 2 or more signs of severity.Results A total of 36.2% of asthmatic patients expressed at least 1 sign of asthma severity, and 13.2% had 2 or more signs. The group with 2 or more signs was older in age and had higher body mass index, a higher rate of tobacco smoking, and lower lung function. Bronchial hyperreactivity, airway inflammation, and sensitization were significantly different among the 3 groups. At a population level, the prevalence of asthma severity was 3.1% for 1 sign and 1.3% for at least 2 signs.Conclusion More than 1 in 3 asthmatic patients show at least 1 sign of asthma severity. The phenotypes of asthma severity are highly diverse, which is important to consider when implementing personalized medicine in asthmatic patients.
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Some studies report that as high as 20% or even more than 30% of asthmatic patients have at least some features of severe disease.
“while some studies report that as high as 20% or even more than 30% of asthmatic patients have at least some features of severe disease (38, 39).”
From Epidemiology of Asthma in Children and Adults (2019) · cites this paper as [39]
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Epidemiology of Asthma in Children and Adults
Dharmage, S. C., Perret, J. L., & Custovic, A. (2019) · Frontiers in Pediatrics · doi:10.3389/fped.2019.00246 · Cited by 1,200 · see citing works
- Authors
- Mincheva, R., Ekerljung, L., Bossios, A., Lundbäck, B., & Lötvall, J.
- Affiliations
- University of Gothenburg (SE)
- Corresponding author
- Lötvall, Jan
- Venue
- Journal of Allergy and Clinical Immunology
- Publisher
- Elsevier BV
- Published
- 2018-06
- Volume
- 141
- Issue
- 6
- Pages
- 2256-2264.e2
- ISSN
- 0091-6749 (ISSN-L)
- OpenAlex
- W2755959215
- Cited by
- 37
- References
- 64
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 5 · 2021: 9 · 2020: 4 · 2019: 10 · 2018: 2
- FWCI
- 3.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Allergy and Clinical Immunology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
- Keywords
- asthma severity, asthma prevalence, asthma phenotypes, rescue medication use, nocturnal symptoms, oral corticosteroid use, emergency department visits, airway hyperresponsiveness, airway inflammation, allergen sensitization, lung function, body mass index, smoking, personalized medicine
- MeSH terms
- Adult, Aged, Asthma, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Sweden, Prevalence
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