Abstract
Background There is limited evidence on the pathways leading to severe asthma and we are presently unable to effectively predict the progression of the disease.
Aim: We aimed to describe the longitudinal trajectories leading to severe asthma and to describe clinical events preceding disease progression in a nationwide population of patients with severe asthma.
Methods We conducted an observational study based on Swedish data from the NORdic Dataset for aSThmA Research (NORDSTAR) research collaboration platform. We identified adult patients with severe asthma in 2018 according to the ERS/ATS definition and used latent class analysis (LCA) to identify trajectories of asthma severity over a ten-year retrospective period from 2018.
Conclusions Four distinct trajectories of severe asthma were identified illustrating different patterns of progression of asthma severity. This may eventually enable the development of better preventive management strategies in severe asthma.
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: The work was financially supported by Novartis and Sanofi & Regeneron Pharmaceuticals.
Conflict of interest: Anna von Bülow reports consulting fees from Novartis, speaker fees from Novartis, GSK, AstraZeneca, travel grants from AstraZeneca, participation in advisory boards with AstraZeneca, Novartis;
Conflict of interest: Susanne Hansen reports speaker fees from AstraZeneca;
Conflict of interest: Patrik Sandin has no conflicts of interest;
Conflict of interest: Olivia Ernstsson has no conflicts of interest;
Conflict of interest: Christer Janson reports no conflicts of interest;
Conflict of interest: Lauri Lehtimäki reports fees for lectures, consultations or advisory board meetings from ALK, Astra Zeneca, Boehringer Ingelheim, Chiesi, GSK, Menarini, Mundipharma, Novartis, Orion and Sanofi;;
Conflict of interest: Hannu Kankaanranta reports consulting fees from AstraZeneca, GSK, Chiesi, MSD, Orion Pharma, Novartis, SanofiGenzyme and speaker fees from AstraZeneca, GSK, Orion Pharma, Boehringer-Ingelheim;
Conflict of interest: Charlotte Ulrik reports grants from Sanofi, Boehringer Ingelheim, AstraZeneca, Novartis, consulting fees from Chiesi, Orion Pharma, Menarini, Takeda, AstraZeneca, TEVA, GSK, lecture fees from Orion, Pharma, AZ, TEVA, and participation in advisory boards with Novartis, GSK, Pfizer, AstraZeneca, Sanofi, Chiesi, Boehringer Ingelheim;
Conflict of interest: Bernt Bøgvald Aarli reports grants from Novartis, consulting fees from AstraZeneca, lecture fees from GSK, AstraZeneca, Sanofi-Aventis, Novartis, Boehringer Ingelheim, participation in advisory boards with GSK, Astra Zeneca, Chiesi Pharma, Novartis and Sanofi;
Conflict of interest: Kirk Geale is a board member of Quantify Research AB, Quantify Research ApS, Quantify Research AS, Quantify HEOR Private Limited, is CEO of Quantify Research AB, Quantify Research ApS, Quantify Research AS and has stock and stock options in Quantify Research AB;
Conflict of interest: Sheila Tuyet Tang is an employee at Sanofi and holds stocks in Sanofi;
Conflict of interest: Maija Wolf is an employee at Novartis Finland;
Conflict of interest: Vibeke Backer reports no conflicts of interest;
Conflict of interest: Ole Hilberg reports consulting fees from Novartis, Sanofi, AstraZeneca, GSK, ALK, MSD, Teva and travel grants from Sanofi;
Conflict of interest: Alan Altraja reports consulting fees from AstraZeneca, Boehringer Ingelheim, GSK, Sanofi, speaker fees from AstraZeneca, Berlin-Chemie Menarini, Boehringer Ingelheim, Norameda (Chiesi), GSK, Sanofi, Zentiva, expert testimony from AstraZeneca, Boehringer Ingelheim, GSK, Sanofi, travel grants from AstraZeneca, Berlin-Chemie Menarini, Boehringer Ingelheim, Norameda (Chiesi), participation in advisory boards with AstraZeneca, Boehringer Ingelheim, GSK, Sanofi, and receipt of equipment from Berlin-Chemie Menarini;
Conflict of interest: Helena Backman reports speaker fees from AstraZeneca, Boehringer Ingelheim, GSK;
Conflict of interest: Dora Ludviksdottir reports speaker fees from GSK and Boeringer-Ingelheim;
Conflict of interest: Unnur Björnsdottir reports speaker fees from Sanofi, AstraZeneca, Novartis, support for travel from Sanofi, participation in advisory boards with Sanofi;
Conflict of interest: Paula Kauppi reports consulting fees from Sobi, speaker fees from GSK, AstraZeneca, and fee for PI for Theravance;
Conflict of interest: Thomas Sandström reports no conflicts of interest;
Conflict of interest: Asger Sverrild reports grants from AstraZeneca, speaker fees from AstraZeneca, Chiesi, GSK, Sanofi-Genzymes, Novartis;
Conflict of interest: Valentyna Yasinska reports lecture fees from GSK, Sanofi, participation in advisory boards with AstraZeneca and GSK;
Conflict of interest: Maritta Kilpeläinen reports no conflicts of interest;
Conflict of interest: Barbro Dahlén reports grants from GSK and Novartis;
Conflict of interest: Arja Viinanen reports consulting fees from AstraZeneca, GSK, speaker fees from GSK, Chiesi, travel grants from AstraZeneca, Sanofi;
Conflict of interest: Leif Bjermer reports speaker fees from AstraZeneca, GSK, Airsonette, Birc, Chiesi, Novartis, Sanofi and participation in advisory boards with AstraZeneca, Chiesi, GSK, Birc, Sanofi;
Conflict of interest: Apostolos Bossios reports speaker fees from GSK, AstraZeneca, Teva, Novartis, travel grants from AstraZeneca, Novartis, participation in advisory boards with GSK, AstraZeneca, Teva, Novartis, Sanofi, is a member of the steering committee of SHARP, Secretary of Assembly 5 (Airway diseases, asthma, COPD, and chronic cough) in the European Respiratory Society and is the vice-president of the Nordic Severe Asthma Network;
Conflict of interest: Celeste Porsbjerg reports grants from AstraZeneca, GSK, Novartis, Teva, Sanofi, Chiesi, ALK, consulting fees from AZ, GSK, Novartis, TEVA, Sanofi, Chiesi, ALK, lecture fees from AZ, GSK, Novartis, TEVA, Sanofi, Chiesi, ALK, participation in advisory boards with AstraZeneca, Novartis, TEVA, Sanofi, ALK.
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- Received December 23, 2022.
- Accepted July 3, 2023.
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