Determinants of persistent asthma in young adults

Lisbet Krogh Traulsen, Anders Halling, Jesper Bælum, Jesper Rømhild Davidsen, Martin Miller, Øyvind Omland, David Sherson, Torben Sigsgaard, Trine Thilsing, Gert Thomsen, Lars Rauff Skadhauge

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Abstract

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.

Original languageEnglish
Article number1478593
JournalEuropean Clinical Respiratory Journal
Volume5
Issue number1
Number of pages9
ISSN2001-8525
DOIs
Publication statusPublished - 2018

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Young Adult
Adrenergic Receptors
Adrenal Cortex Hormones
Age of Onset
Interviews
Chronic Obstructive Pulmonary Disease
Population
Respiration

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title = "Determinants of persistent asthma in young adults",
abstract = "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.",
author = "Traulsen, {Lisbet Krogh} and Anders Halling and Jesper B{\ae}lum and Davidsen, {Jesper R{\o}mhild} and Martin Miller and {\O}yvind Omland and David Sherson and Torben Sigsgaard and Trine Thilsing and Gert Thomsen and Skadhauge, {Lars Rauff}",
year = "2018",
doi = "10.1080/20018525.2018.1478593",
language = "English",
volume = "5",
journal = "European Clinical Respiratory Journal",
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Determinants of persistent asthma in young adults. / Traulsen, Lisbet Krogh; Halling, Anders; Bælum, Jesper; Davidsen, Jesper Rømhild; Miller, Martin; Omland, Øyvind; Sherson, David; Sigsgaard, Torben; Thilsing, Trine; Thomsen, Gert; Skadhauge, Lars Rauff.

In: European Clinical Respiratory Journal, Vol. 5, No. 1, 1478593, 2018.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Determinants of persistent asthma in young adults

AU - Traulsen, Lisbet Krogh

AU - Halling, Anders

AU - Bælum, Jesper

AU - Davidsen, Jesper Rømhild

AU - Miller, Martin

AU - Omland, Øyvind

AU - Sherson, David

AU - Sigsgaard, Torben

AU - Thilsing, Trine

AU - Thomsen, Gert

AU - Skadhauge, Lars Rauff

PY - 2018

Y1 - 2018

N2 - 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.

AB - 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.

U2 - 10.1080/20018525.2018.1478593

DO - 10.1080/20018525.2018.1478593

M3 - Journal article

VL - 5

JO - European Clinical Respiratory Journal

JF - European Clinical Respiratory Journal

SN - 2001-8525

IS - 1

M1 - 1478593

ER -