Abstract
Background Real-life evidence on prevalence and management of severe asthma is limited. Nationwide population registries across the Nordic countries provide unique opportunities to describe prevalence and management patterns of severe asthma at population level.
Aim In nationwide register data from Sweden, Norway, and Finland, we examined the prevalence of severe asthma and the proportion of severe asthma patients being managed in specialist care.
Methods This is a cross-sectional study based on the NORdic Dataset for aSThmA Research (NORDSTAR) research collaboration platform. We identified patients with severe asthma in adults (≥18 years) and in children (6–17 years) in 2018 according to the ERS/ATS definition. Patients managed in specialist care were those with an asthma-related specialist outpatient contact (only available in Sweden and Finland).
Results Overall, we identified 598 242 patients with current asthma in Sweden, Norway, and Finland in 2018. Among those, the prevalence of severe asthma was 3.5%, 5.4% and 5.2% in adults and 0.4%, 1.0%, and 0.3% in children in Sweden, Norway, and Finland, respectively. In Sweden and Finland, 37% and 40% of adult patients with severe asthma and ≥2 exacerbations were managed in specialist care; in children the numbers were 56% and 41%, respectively.
Conclusion In three Nordic countries, population-based nationwide data demonstrated similar prevalence of severe asthma. In children, severe asthma was a rare condition. Notably, a large proportion of patients with severe asthma was not managed by a respiratory specialist, suggesting the need for increased recognition of severe asthma in primary care.
Footnotes
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Conflict of interest: The work was financially supported by Novartis and Sanofi & Regeneron Pharmaceuticals. Susanne Hansen reports no conflicts of interest.
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: Patrik Sandin has no conflicts of interest.
Conflict of interest: Olivia Ernstsson has no conflicts of interest.
Conflict of interest: Christer Janson reports speaker fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GSK, Novartis, Orion Pharma, Sanofi and expert testimony payments from AstraZeneca, Boehringer Ingelheim, Chiesi, GSK, Novartis, Orion Pharma, Sanofi.
Conflict of interest: Lauri Lehtimäki reports consulting fees from AstraZeneca, GSK and speaker fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GSK, Novartis, Orion Pharma, Sanofi.
Conflict of interest: Hannu Kankaanranta reports consulting fees from AstraZeneca, GSK, Chiesi, MSD, Orion Pharma, Novartis, SanofiGenzyme and speaker fees from AstraZeneca, GSK, Chiesi, Mundipharma, Orion Pharma, SanofiGenzyme.
Conflict of interest: Charlotte Ulrik reports grants from Sanofi, Boehringer Ingelheim, AstraZeneca, Novartis, consulting fees from Orion Pharma, AstraZeneca, Teva, and participation in advisory boards with Novartis, GSK, AstraZeneca, Sanofi, Chiesi, Boehringer Ingelheim.
Conflict of interest: Bernt Bøgvald Aarli reports consulting fees from GSK, AstraZeneca, lecture fees from GSK, AstraZeneca, Sanofi-Aventis Norge, Novartis, Boehringer Ingelheim, participation in advisory boards with GSK, Astra Zeneca, and Sanofi-Aventis Norge.
Conflict of interest: Hanna Fues Wahl has no conflicts of interest.
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: Tom Larsen is an employee at Novartis Norway.
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, Teva, 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, Sanofi.
Conflict of interest: Maritta Kilpeläinen reports no conflicts of interest.
Conflict of interest: Arja Viinanen reports consulting fees from GSK, speaker fees from AstraZeneca, ALK, GSK, Boehringer Ingelheim, Chiesi, travel grants from AstraZeneca, Sanofi, Boehringer Ingelheim.
Conflict of interest: Dora Ludviksdottir reports travel grants from GSK, AstraZeneca.
Conflict of interest: Paula Kauppi reports no conflicts of interest.
Conflict of interest: Asger Sverrild reports grants from AstraZeneca, consulting fees from Novartis, speaker fees from AstraZeneca, Chiesi, travel grants from Teva, participation in advisory boards with Chiesi, Sanofi-Genzymes.
Conflict of interest: Sverre Lehmann reports no conflicts of interest.
Conflict of interest: Vibeke Backer reports no conflicts of interest.
Conflict of interest: Valentyna Yasinska reports lecture fees from GSK, Sanofi, participation in advisory boards with AstraZeneca, Chiesi, GSK.
Conflict of interest: Tina Skjold reports no conflicts of interest, Jussi Karjalainen reports consulting fees from AstraZeneca, GSK, MSD, Novartis, lecture fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GSK, MSD, MundiPharma, Novartis, Orion Pharma.
Conflict of interest: Apostolos Bossios reports lecture 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 8, 2022.
- Accepted December 28, 2022.
- Copyright ©The authors 2023
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