Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

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 five European electronic databases we created a cohort encompassing adult patients with doctor-diagnosed asthma in 2008-2013. Patients were categorized based on their age at asthma onset: childhood-onset (age at onset < 18 years), adult-onset (age at onset 18-40 years) and late-onset asthma (age at onset >=40 years). Comorbidities were assessed at study entry. For each characteristic and comorbidity, odds ratios (OR) and age- and sex-adjusted OR(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 to 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 to 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), gastro-oesophageal 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)). CONCLUSION: 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 often uncontrolled asthma.

Original publication

DOI

10.1016/j.jaip.2022.03.019

Type

Journal article

Journal

J allergy clin immunol pract

Publication Date

07/04/2022

Keywords

adults, age at onset, asthma, comorbidity, epidemiology –exacerbations, general population