Longitudinal Asthma Patterns in Italian Adult General Population Samples: Host and Environmental Risk Factors

Abstract

Background: Asthma patterns are not well established in epidemiological studies. Aim: To assess asthma patterns and risk factors in an adult general population sample. Methods: In total, 452 individuals reporting asthma symptoms/diagnosis in previous surveys participated in the AGAVE survey (2011–2014). Latent transition analysis (LTA) was performed to detect baseline and 12-month follow-up asthma phenotypes and longitudinal patterns. Risk factors associated with longitudinal patterns were assessed through multinomial logistic regression. Results: LTA detected four longitudinal patterns: persistent asthma diagnosis with symptoms, 27.2%; persistent asthma diagnosis without symptoms, 4.6%; persistent asthma symptoms without diagnosis, 44.0%; and ex -asthma, 24.1%. The longitudinal patterns were differently associated with asthma comorbidities. Persistent asthma diagnosis with symptoms showed associations with passive smoke (OR 2.64, 95% CI 1.10–6.33) and traffic exposure (OR 1.86, 95% CI 1.02–3.38), while persistent asthma symptoms (without diagnosis) with passive smoke (OR 3.28, 95% CI 1.41–7.66) and active smoke (OR 6.24, 95% CI 2.68–14.51). Conclusions: LTA identified three cross-sectional phenotypes and their four longitudinal patterns in a real-life setting. The results highlight the necessity of a careful monitoring of exposure to active/passive smoke and vehicular traffic, possible determinants of occurrence of asthma symptoms (with or without diagnosis). Such information could help affected patients and physicians in prevention and management strategies.

The severe asthma registries: a way to better know and fight the disease

“…Data about follow-up will be soon available. More recently, results about the longitudinal asthma patterns in the general population sample of 452 subjects were published (12). SANI was established in 2017 and it currently consists of 64 clinical centers spread throughout the country.…”

What Is Asthma?

“…Andy Bush, always on the cutting edge of knowledge, explains to us what child is a good candidate for biological therapy and revisits the need to establish phenotypes (which maybe not be as stable as we would like them) to make better decisions [ 4 ]. Phenotypes (in adults) are also the topic of the paper by Sara Maio and the AGAVE Pisa group [ 5 ]. They very elegantly show, through latent transition analysis, that some environmental factors are crucial for defining some phenotypes and even that there may be specific forms of asthma associated to tobacco smoke or air pollution.…”