Risk factors for asthma exacerbations
Background: The Global Initiative for Asthma (GINA) advises evaluation of risk factors for exacerbations. Patients with adult-onset asthma often have a problematic disease presentation with comorbidities. Not much information exists about the prevalence of exacerbation risk factors in adult-onset as...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-08-01
|
| Series: | Journal of Allergy and Clinical Immunology: Global |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772829325001213 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849344357621039104 |
|---|---|
| author | Lauri Nordman, MD Iida Vähätalo, PhD Leena E. Tuomisto, MD, PhD Onni Niemelä, MD, PhD Minna Tommola, MD, PhD Lauri Lehtimäki, MD, PhD Pinja Ilmarinen, PhD Hannu Kankaanranta, MD, PhD |
| author_facet | Lauri Nordman, MD Iida Vähätalo, PhD Leena E. Tuomisto, MD, PhD Onni Niemelä, MD, PhD Minna Tommola, MD, PhD Lauri Lehtimäki, MD, PhD Pinja Ilmarinen, PhD Hannu Kankaanranta, MD, PhD |
| author_sort | Lauri Nordman, MD |
| collection | DOAJ |
| description | Background: The Global Initiative for Asthma (GINA) advises evaluation of risk factors for exacerbations. Patients with adult-onset asthma often have a problematic disease presentation with comorbidities. Not much information exists about the prevalence of exacerbation risk factors in adult-onset asthma patients. Objective: We evaluated the prevalence of exacerbation risk factors listed in the 2023 GINA Report and their association with exacerbations in patients with adult-onset asthma. Methods: In the Seinäjoki Adult Asthma Study, 203 patients with adult-onset asthma were followed for 12 years. Data were available for 17 of the 21 GINA risk factors. Exacerbation was defined as an unplanned health care visit with asthma exacerbation mentioned in the medical health records. ClinicalTrials.gov NCT02733016. Results: On average, patients had 3.8 asthma exacerbation risk factors, with poor adherence (54.7%), chronic rhinosinusitis (54.2%), and smoking (52.7%) being the most common. Four patients (2.0%) had no risk factors. Oral corticosteroid use and the number of exacerbations increased with the number of risk factors. Exacerbations were positively associated with gastroesophageal reflux disease (odds ratio [OR], 5.0; 95% confidence interval [CI], 1.7-15.1; P = .004) and age >50 years (OR, 2.3; 95% CI, 1.1-4.8; P = .021) in univariate analyses. After adjustments by sex, pack years, and body mass index, only gastroesophageal reflux disease remained as a statistically significant risk factor (OR, 4.5; 95% CI, 1.5-14.0; P = .009). Conclusions: Exacerbation risk factors are common in patients with adult-onset asthma, and the value of identifying a single risk factor may be low. Patients with multiple risk factors and/or gastroesophageal reflux disease should be emphasized in clinical practice. |
| format | Article |
| id | doaj-art-cb3e1dbaa49245b2819e3c8ef5cc6ae0 |
| institution | Kabale University |
| issn | 2772-8293 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Allergy and Clinical Immunology: Global |
| spelling | doaj-art-cb3e1dbaa49245b2819e3c8ef5cc6ae02025-08-20T03:42:40ZengElsevierJournal of Allergy and Clinical Immunology: Global2772-82932025-08-014310052010.1016/j.jacig.2025.100520Risk factors for asthma exacerbationsLauri Nordman, MD0Iida Vähätalo, PhD1Leena E. Tuomisto, MD, PhD2Onni Niemelä, MD, PhD3Minna Tommola, MD, PhD4Lauri Lehtimäki, MD, PhD5Pinja Ilmarinen, PhD6Hannu Kankaanranta, MD, PhD7Faculty of Medicine and Health Technology, Tampere University, Tampere, FinlandFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, FinlandFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, FinlandFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Laboratory Medicine, Seinäjoki Central Hospital, Seinäjoki, FinlandDepartment of Respiratory Medicine, Hospital Nova of Central Finland, Jyväskylä, FinlandFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Allergy Centre, Tampere University Hospital, Tampere, FinlandFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, FinlandFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland; Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Corresponding author: Hannu Kankaanranta, MD, PhD, Krefting Research Centre, University of Gothenburg, Medicinaregatan 1F, 41390 Göteborg, Sweden.Background: The Global Initiative for Asthma (GINA) advises evaluation of risk factors for exacerbations. Patients with adult-onset asthma often have a problematic disease presentation with comorbidities. Not much information exists about the prevalence of exacerbation risk factors in adult-onset asthma patients. Objective: We evaluated the prevalence of exacerbation risk factors listed in the 2023 GINA Report and their association with exacerbations in patients with adult-onset asthma. Methods: In the Seinäjoki Adult Asthma Study, 203 patients with adult-onset asthma were followed for 12 years. Data were available for 17 of the 21 GINA risk factors. Exacerbation was defined as an unplanned health care visit with asthma exacerbation mentioned in the medical health records. ClinicalTrials.gov NCT02733016. Results: On average, patients had 3.8 asthma exacerbation risk factors, with poor adherence (54.7%), chronic rhinosinusitis (54.2%), and smoking (52.7%) being the most common. Four patients (2.0%) had no risk factors. Oral corticosteroid use and the number of exacerbations increased with the number of risk factors. Exacerbations were positively associated with gastroesophageal reflux disease (odds ratio [OR], 5.0; 95% confidence interval [CI], 1.7-15.1; P = .004) and age >50 years (OR, 2.3; 95% CI, 1.1-4.8; P = .021) in univariate analyses. After adjustments by sex, pack years, and body mass index, only gastroesophageal reflux disease remained as a statistically significant risk factor (OR, 4.5; 95% CI, 1.5-14.0; P = .009). Conclusions: Exacerbation risk factors are common in patients with adult-onset asthma, and the value of identifying a single risk factor may be low. Patients with multiple risk factors and/or gastroesophageal reflux disease should be emphasized in clinical practice.http://www.sciencedirect.com/science/article/pii/S2772829325001213Adult-onsetasthmaexacerbationrisk factorprevalencefollow-up |
| spellingShingle | Lauri Nordman, MD Iida Vähätalo, PhD Leena E. Tuomisto, MD, PhD Onni Niemelä, MD, PhD Minna Tommola, MD, PhD Lauri Lehtimäki, MD, PhD Pinja Ilmarinen, PhD Hannu Kankaanranta, MD, PhD Risk factors for asthma exacerbations Journal of Allergy and Clinical Immunology: Global Adult-onset asthma exacerbation risk factor prevalence follow-up |
| title | Risk factors for asthma exacerbations |
| title_full | Risk factors for asthma exacerbations |
| title_fullStr | Risk factors for asthma exacerbations |
| title_full_unstemmed | Risk factors for asthma exacerbations |
| title_short | Risk factors for asthma exacerbations |
| title_sort | risk factors for asthma exacerbations |
| topic | Adult-onset asthma exacerbation risk factor prevalence follow-up |
| url | http://www.sciencedirect.com/science/article/pii/S2772829325001213 |
| work_keys_str_mv | AT laurinordmanmd riskfactorsforasthmaexacerbations AT iidavahatalophd riskfactorsforasthmaexacerbations AT leenaetuomistomdphd riskfactorsforasthmaexacerbations AT onniniemelamdphd riskfactorsforasthmaexacerbations AT minnatommolamdphd riskfactorsforasthmaexacerbations AT laurilehtimakimdphd riskfactorsforasthmaexacerbations AT pinjailmarinenphd riskfactorsforasthmaexacerbations AT hannukankaanrantamdphd riskfactorsforasthmaexacerbations |