RT Journal Article SR Electronic T1 Prevalence and management of severe asthma in the Nordic countries – findings from the NORDSTAR cohort JF ERJ Open Research JO erjor FD European Respiratory Society SP 00687-2022 DO 10.1183/23120541.00687-2022 A1 Susanne Hansen A1 Anna von Bülow A1 Patrik Sandin A1 Olivia Ernstsson A1 Christer Janson A1 Lauri Lehtimäki A1 Hannu Kankaanranta A1 Charlotte Ulrik A1 Bernt Bøgvald Aarli A1 Hanna Fues Wahl A1 Kirk Geale A1 Sheila Tuyet Tang A1 Maija Wolf A1 Tom Larsen A1 Alan Altraja A1 Helena Backman A1 Maritta Kilpeläinen A1 Arja Viinanen A1 Dora Ludviksdottir A1 Paula Kauppi A1 Asger Sverrild A1 Sverre Lehmann A1 Vibeke Backer A1 Valentyna Yasinska A1 Tina Skjold A1 Jussi Karjalainen A1 Apostolos Bossios A1 Celeste Porsbjerg YR 2023 UL http://openres.ersjournals.com/content/early/2023/01/05/23120541.00687-2022.abstract AB 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.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. 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 ERJOR 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. 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.