Characterization of Asthma by Age of Onset: A Multi-Database Cohort Study

Esmé J. Baan, Emmely W. de Roos, Marjolein Engelkes, Maria de Ridder, Lars Pedersen, Klara Berencsi, Dani Prieto-Alhambra, Francesco Lapi, Melissa K. Van Dyke, Peter Rijnbeek, Guy G. Brusselle, Katia M.C. Verhamme*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)
2 Downloads (Pure)

Abstract

Background: Asthma can occur at any age but the differences in patient characteristics between childhood-, adult-, and late-onset asthma are not well understood. Objective: To investigate differences in patients’ characteristics by age at asthma onset. Methods: From 5 European electronic databases, we created a cohort encompassing adult patients with doctor-diagnosed asthma in 2008 to 2013. Patients were categorized based on their age at asthma onset: childhood-onset (age at onset < 18 y), adult-onset (age at onset 18–40 y), and late-onset asthma (age at onset ≥ 40 y). Comorbidities were assessed at study entry. For each characteristic and comorbidity, odds ratios and age- and sex-adjusted odds ratios (ORadj) comparing asthma-onset categories were estimated per database and combined in a meta-analysis using a random effect model. Results: In total, 586,436 adult asthma patients were included, 81,691 had childhood-onset, 218,184 adult-onset, and 286,561 late-onset asthma. Overall, 7.3% had severe asthma. Subjects with adult-onset compared with childhood-asthma had higher risks for overweight/obesity (ORadj 1.4; 95% CI 1.1–1.8) and lower risks for atopic disorders (ORadj 0.8; 95% CI 0.7–0.95). Patients with late-onset compared with adult-onset asthma had higher risks for nasal polyposis (ORadj 1.8; 95% CI 1.2–2.6), overweight/obesity (ORadj 1.3; 95% CI 1.2–1.4), gastroesophageal reflux disease (ORadj 1.4; 95% CI 1.2–1.7), and diabetes (ORadj 2.3; 95% CI 1.8–2.9). A significant association between late-onset asthma and uncontrolled asthma was observed (ORadj 2.8; 95% CI 1.7–4.5). Conclusions: This international study demonstrates clear differences in comorbidities between childhood-, adult-, and late-onset asthma phenotypes in adults. Furthermore, patients with late-onset asthma had more frequent uncontrolled asthma.

Original languageEnglish
Pages (from-to)1825-1834.e8
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume10
Issue number7
Early online date7 Apr 2022
DOIs
Publication statusPublished - 1 Jul 2022

Bibliographical note

Funding Information:
This project was supported by an unconditional research grant by GlaxoSmithKline (GSK) (PRJ2284).Conflicts of interest: M. Engelkes reports grants from GSK during the conduct of the study. M. de Ridder reports grants from GSK during the conduct of the study. D. Prieto-Alhambra reports grants and other from AMGEN; grants, nonfinancial support, and other from UCB Biopharma; grants from Les Laboratoires Servier, outside the submitted work; and Janssen, on behalf of IMI-funded EHDEN and EMIF consortiums; and Synapse Management Partners have supported training programs organized by D. Prieto-Alhambra's department and open for external participants. F. Lapi reports grants from Chiesi, GSK, and Novartis during the conduct of the study. M. K. Van Dyke is a GSK employee and shareholder. P. Rijnbeek receives an unconditional grant from Janssen Research & Development and funding through the Innovative Medicines Initiative. G. G. Brusselle has received fees for advisory boards or lectures from AstraZeneca, Boehringer-Ingelheim, Chiesi, GlaxoSmithKline, Novartis, Sanofi, and Teva. K. M. C. Verhamme works for a research group that, in the past, received unconditional research grants from Yamanouchi, Pfizer/Boehringer Ingelheim, Novartis, Chiesi, Amgen, and UCB. The rest of the authors declare that they have no relevant conflicts of interest.

Funding Information:
Conflicts of interest: M. Engelkes reports grants from GSK during the conduct of the study. M. de Ridder reports grants from GSK during the conduct of the study. D. Prieto-Alhambra reports grants and other from AMGEN; grants, nonfinancial support, and other from UCB Biopharma; grants from Les Laboratoires Servier , outside the submitted work; and Janssen, on behalf of IMI-funded EHDEN and EMIF consortiums; and Synapse Management Partners have supported training programs organized by D. Prieto-Alhambra's department and open for external participants. F. Lapi reports grants from Chiesi , GSK , and Novartis during the conduct of the study. M. K. Van Dyke is a GSK employee and shareholder. P. Rijnbeek receives an unconditional grant from Janssen Research & Development and funding through the Innovative Medicines Initiative. G. G. Brusselle has received fees for advisory boards or lectures from AstraZeneca , Boehringer-Ingelheim, Chiesi , GlaxoSmithKline , Novartis , Sanofi , and Teva. K. M. C. Verhamme works for a research group that, in the past, received unconditional research grants from Yamanouchi, Pfizer / Boehringer Ingelheim , Novartis , Chiesi , Amgen , and UCB . The rest of the authors declare that they have no relevant conflicts of interest.

Funding Information:
This project was supported by an unconditional research grant by GlaxoSmithKline (GSK) (PRJ2284).

Publisher Copyright:
© 2022 The Authors

Fingerprint

Dive into the research topics of 'Characterization of Asthma by Age of Onset: A Multi-Database Cohort Study'. Together they form a unique fingerprint.

Cite this