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From mild-to-moderate to severe asthma: Risk factors and patient profiles from the NORDSTAR cohort
Susanne Hansen1,2, Anna von Bülow1,3, Alexandra Cooper2
1Department of Respiratory Medicine and Infectious Diseases, Bispebjerg Hospital, Copenhagen, Denmark.
Summary
Few patients with mild-to-moderate asthma progress to severe asthma after their first exacerbation. However, specific risk factors like age and eosinophil counts identify high-risk individuals who may benefit from early intervention.
Area of Science:
- Pulmonary Medicine
- Clinical Epidemiology
Background:
- The transition from mild-to-moderate to severe asthma is not fully understood.
- Identifying predictors of asthma progression is crucial for effective management.
Purpose of the Study:
- To evaluate the risk of developing severe asthma after the initial exacerbation in mild-to-moderate asthma patients.
- To identify risk factors and patient profiles associated with asthma progression.
Main Methods:
- An observational cohort study utilized Danish registry data (NORDSTAR) from 2000-2018.
- Adults with mild-to-moderate asthma experiencing their first exacerbation were followed for five years.
- Multivariable logistic regression analyzed baseline risk factors for progression to severe asthma.
Main Results:
- Overall, 4.1% of patients progressed to severe asthma within five years.
- Key risk factors included age 40-49, medium-dose inhaled corticosteroid (ICS) use, high short-acting beta-agonist use, recurrent respiratory infections, and elevated blood eosinophils.
- A patient profile with specific risk factors faced a 30.4% five-year risk of progression.
Conclusions:
- While overall progression to severe asthma is low, specific high-risk profiles exist.
- Early identification of these high-risk patients is essential.
- Further research is needed to determine if early interventions can alter the risk of progression.
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