Higher mortality of adults with asthma: A 15‐year follow‐up of a population‐based cohort

Lemmetyinen, Riikka; Karjalainen, Jussi; But, Anna; Renkonen, Risto; Pekkanen, Juha; Toppila‐Salmi, Sanna; Haukka, Jari

doi:10.1111/all.13431

Cited by 52 publications

(83 citation statements)

References 42 publications

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“…This multimorbidity profile showed an increased risk of subsequent uncontrolled asthma and asthma exacerbations as compared to a profile characterized by “few multimorbidity,” and importantly, this risk was of similar magnitude than the risk observed for the “metabolic multimorbidity” profile . Thus, allergic diseases affect morbidity lifelong, although in terms of mortality, previous studies indicate that AR/AC did not explain excess mortality among asthmatic adults . Overall, it is likely that asthma with allergic multimorbidity represents phenotypes that considerably differ from asthma alone in terms of mechanisms, severity, and prognosis.…”

Section: Discussionmentioning

confidence: 78%

“…The Adult Asthma in Finland is a population‐based matched case‐control study conducted in 1997 (Figure ) as previously described . This study collected information from 1400 asthma patients older than 30 years of age with a recent asthma diagnosis (<1 year).…”

Section: Methodsmentioning

confidence: 99%

“…As there is still limited knowledge of the putative causal effect between allergic multimorbidity and asthma in adults, the aim was to assess the association between allergic multimorbidity and adult-onset asthma in a large population-based case-control study on asthma, the Adult Asthma in Finland. 13 We hypothesized that each allergic disease, AR, AD, and AC, is positively associated with adult-onset asthma and that the asthma risk increases with the number of allergic multimorbidities. Our secondary hypothesis was that the asthma risk associated with allergic multimorbidity increases with younger age.…”

Section: G R a P H I C A L Abstractmentioning

confidence: 99%

“…The Adult Asthma in Finland is a population-based matched case-control study conducted in 1997 (Figure 1) as previously described. 13,14 This study collected information from 1400 asthma patients older than 30 features, and asthma course, and at least one of the following physiologic criteria: (a) a variation of 20% or greater in diurnal peak expiratory flow (PEF) recording (reference to maximal value); (b) an increase of 15% or greater in PEF or forced expiratory volume in 1 second (FEV1) with β-agonist; or (c) an decrease of 15% or greater in PEF or FEV1 in exercise testing. This method of case ascertainment has been validated earlier.…”

Section: Study Populationmentioning

confidence: 99%

“…Early detection and prevention of allergic multimorbidity that persists in adulthood could putatively reduce asthma burden in adults. As there is still limited knowledge of the putative causal effect between allergic multimorbidity and asthma in adults, the aim was to assess the association between allergic multimorbidity and adult‐onset asthma in a large population‐based case‐control study on asthma, the Adult Asthma in Finland . We hypothesized that each allergic disease, AR, AD, and AC, is positively associated with adult‐onset asthma and that the asthma risk increases with the number of allergic multimorbidities.…”

Section: Introductionmentioning

confidence: 99%

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Risk of adult‐onset asthma increases with the number of allergic multimorbidities and decreases with age

Toppila‐Salmi

Chanoine

Karjalainen

et al. 2019

Allergy

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Background:The aim was to study the association between allergic multimorbidity and adult-onset asthma considering the number of allergic diseases and the age effect. Methods:We used population-based data from Finnish national registers including 1205 adults over 30 years of age with recently diagnosed asthma (age range: 30-93), matched for gender, age, and living region with one or two controls (n = 2050).Allergic rhinitis (AR), allergic conjunctivitis (AC), and allergic dermatitis (AD) were defined from self-completed questionnaire. Conditional logistic regression adjusted on potential confounders (smoking, growing in countryside, childhood hospitalized infection/pneumonia, parental asthma/allergy, parental smoking, education level, professional training, number of siblings, and birth order) was applied to estimate the asthma risk associated with allergic multimorbidity.Results: A total of 1118 cases with asthma and 1772 matched controls were included [mean (SD, min-max) 53 (11, 31-71) years, 37% men)]. AR, AC, and AD were reported by 50.2%, 39.6%, and 33.8%, respectively, among subjects with asthma and 26.1%, 20.0%, and 23.5%, respectively, among controls. Compared to nonatopics, adult-onset asthma increased with the number of allergic diseases; adjusted OR for | 2407 TOPPILA-SALMI eT AL

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Section: Discussionmentioning

confidence: 78%

Section: Methodsmentioning

confidence: 99%

Section: G R a P H I C A L Abstractmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Risk of adult‐onset asthma increases with the number of allergic multimorbidities and decreases with age

Toppila‐Salmi

Chanoine

Karjalainen

et al. 2019

Allergy

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Risk factors of NSAID‐exacerbated respiratory disease: A population‐based study

Helevä,

Murtomäki,

Huhtala

et al. 2023

Clinical & Translational All

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BackgroundAsthma with NSAID‐exacerbated respiratory disease (NERD) is associated with uncontrolled or severe asthma. NERD patients are more prone to severe allergic reactions and their asthma exacerbations lead to hospitalisations twice as often compared to patients with non‐NERD‐asthma. NERD patients are prone to recurrent nasal polyposis requiring frequent endoscopic sinus surgeries. However, the early risk factors of NERD are not fully understood. The aim was to identify risk factors of NERD among patients with adult‐onset asthma.MethodsWe used data from 1350 population‐based adult asthmatics with adult‐onset asthma from Finnish national registers. NERD was defined as self‐reported wheeze or other typical respiratory symptoms after ingestion of NSAIDs. Thirty‐six covariates covering several domains (personal characteristics, life‐style, early life factors, asthma characteristics and multimorbidities) were selected based on literature and were studied in association with NERD using logistic regressions.ResultsThe study population included 153 (11.3%) asthmatics with NERD. Thirty‐six covariates were entered in univariate logistic regression analysis, in which 23 were associated with NERD (p < 0.05). These variables were entered in a multivariable logistic regression model in which allergic respiratory symptoms, female sex, osteoarthritis, difficult asthma, nasal polyps, second‐hand smoke exposure at home, having 3 or more older siblings and being overweight were significantly associated with asthma with NERD (p < 0.05). Overweight decreased the risk of NERD, other factors increased it.ConclusionAccording to our study, risk factors of NERD in part are associated with female sex, BMI, exposure to tobacco smoke, allergy, orthopaedic disorders and infection history, and their early recognition might thus be important to manage the burden of NERD.

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Conjunctivitis in Dupilumab Clinical Trials for Adolescents with Atopic Dermatitis or Asthma

et al. 2021

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Background Conjunctivitis is a known comorbidity of atopic dermatitis. Dupilumab clinical trials for moderate-to-severe atopic dermatitis in adults showed a higher conjunctivitis incidence for dupilumab-treated patients than placebo-treated patients, whereas trials for uncontrolled asthma reported lower rates for both dupilumab and placebo. Objective The objective of this study was to evaluate the incidence and severity of conjunctivitis in dupilumab clinical trials in adolescents with moderate-to-severe atopic dermatitis or uncontrolled asthma. Methods We evaluated the incidence of conjunctivitis in adolescents (aged 12 to < 18 years) in three phase III trials. Ocular events were diagnosed and treated based on patient-reported symptoms and an external eye examination by study investigators, in most cases without an ophthalmologic referral. In LIBERTY AD ADOL (16-week, randomized, placebo-controlled, double-blinded trial), adolescents with moderate-to-severe atopic dermatitis were randomized to subcutaneous placebo, dupilumab 300 mg every 4 weeks, or dupilumab every 2 weeks (200 mg, patients < 60 kg at baseline; 300 mg, ≥ 60 kg at baseline). In LIBERTY AD PED-OLE (open-label extension), pediatric patients from previous dupilumab atopic dermatitis trials received dupilumab 2 mg/kg or 4 mg/kg weekly (up to 300 mg) or 300 mg every 4 weeks. In LIBERTY ASTHMA QUEST (randomized, double-blinded, placebo-controlled trial), patients with uncontrolled moderate-to-severe asthma were randomized to 52 weeks of add-on therapy with dupilumab 200 or 300 mg every 2 weeks or matched-volume placebo. Results In ADOL, more dupilumab-treated (17/165; 10.3%) than placebo-treated patients (4/85; 4.7%) reported one or more conjunctivitis event. All events were mild to moderate in severity; 12 (7.3%) dupilumab-treated and 4 (4.7%) placebo-treated patients received treatment. Most patients with conjunctivitis (dupilumab, 12/17; placebo, 4/4) recovered/resolved during the treatment period. The risk of conjunctivitis showed no relationship with dupilumab serum concentration. In PED-OLE, 12/275 adolescents (4.4%) reported one or more conjunctivitis event. Most conjunctivitis events were mild to moderate. Ten patients received treatment for conjunctivitis. Ten patients recovered/resolved during the study. In QUEST, similar low proportions of dupilumab-treated (2/68, 2.9%) and placebo-treated (1/39, 2.6%) adolescents reported one or more conjunctivitis event. All events were mild to moderate. One dupilumab-treated patient received treatment for conjunctivitis. All cases recovered/resolved during the study. No patients in these trials discontinued study treatment temporarily or permanently because of conjunctivitis. In ADOL, one case of unspecified viral keratitis (specific viral etiology not known) in the dupilumab 300-mg every 4 weeks group and one case of allergic blepharitis in the placebo group were reported; both events resolved during ...

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Higher mortality of adults with asthma: A 15‐year follow‐up of a population‐based cohort

Cited by 52 publications

References 42 publications

Risk of adult‐onset asthma increases with the number of allergic multimorbidities and decreases with age

Risk of adult‐onset asthma increases with the number of allergic multimorbidities and decreases with age

Risk factors of NSAID‐exacerbated respiratory disease: A population‐based study

Conjunctivitis in Dupilumab Clinical Trials for Adolescents with Atopic Dermatitis or Asthma

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