TY - JOUR T1 - Temporal change in pediatric asthma exacerbation rates - a nationwide Swedish asthma cohort (HERA) JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2021.PA2026 VL - 58 IS - suppl 65 SP - PA2026 AU - Erik Melén AU - Bright Nwaru AU - Fredrik Wiklund AU - Magnus Ekström AU - Sofie de Fine Licht AU - Gunilla Telg AU - Christer Janson Y1 - 2021/09/05 UR - http://erj.ersjournals.com/content/58/suppl_65/PA2026.abstract N2 - Background: Asthma is the most common chronic disease in children, with a consistent burden on healthcare. The aim was to evaluate temporal change in exacerbations in a secondary care asthma population.Methods: This nationwide study included patients aged 0-17 years at their first asthma diagnosis by a secondary care specialist during 2006-2015. Exacerbations (hospitalizations, emergency visits and OCS claims) were identified in the Patient and Prescription registries during the year after asthma diagnosis. Exacerbation time trends were expressed as annual rate ratios (RR) using negative binominal models, age and sex adjusted (2006 as reference).Results: In total, 168,237 patients were included: mean age 4.3 (SD 4.7) years, 40.1% females. From 2006-2015, risk of asthma exacerbation in patients aged 0-5 years decreased linearly by 34% (p-value for trend <0.001); RR in 2015 0.66 (95% CI 0.61-0.72). The decline in this age group was strongest in exacerbation-related hospitalizations, RR 0.56 (0.49-0.63). Patients aged 6-17 showed stable exacerbation rates during 2006-2011, in 2012-2013 dropping to 0.74 (0.64-0.86) and increased slightly thereafter; RR in 2015 of 0.88 (0.76-1.01). The trend was mainly driven by a drop in OCS-related exacerbations from 2012 and onwards.Conclusions: The risk of asthma exacerbations the year after diagnosis among children and adolescents in secondary care in Sweden, decreased from 2006 to 2015, mainly driven by a decline in hospitalizations and OCS exacerbations for patients aged 0-5 and 6-17, respectively. Improved asthma management and changes in environmental exposure such as declining parental smoking may have influenced this trend.Study sponsor: AstraZenecaFootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA2026.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only). ER -