Observational studyThe European respiratory journal2023
Severe asthma trajectories in adults: findings from the NORDSTAR cohort.
Observational study in The European respiratory journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 18 citations in OpenAlex.
- From mild-to-moderate to severe asthma: risk factors and patient profiles from the NORDSTAR cohort.American journal of respiratory and critical care medicine · 2026Observational
- Early Intervention With Biologics for Asthma Remission: Promising or Premature?Respirology (Carlton, Vic.) · 2026Article
- Long-Term, Real-World Effectiveness of Allergen Immunotherapy in Children and Adolescents With Allergic Rhinitis and Asthma.Allergy · 2025Article
- Osteoporosis in Severe Asthmatic Patients: Data from the Severe Asthma Network in Italy (SANI) Registry.Journal of clinical medicine · 2025Article
- Review
- Profile of mild/moderate asthma patients: Baseline data from the MANI cohort.The World Allergy Organization journal · 2025Article
- Pre-biologic disease trajectories are associated with morbidity burden and biologic treatment response in severe asthma.The European respiratory journal · 2025Article
- Impact of Asthma Severity and Exacerbation Frequency on Burden of Disease Related Costs in Finland.Journal of asthma and allergy · 2025Article
- Longitudinal multi-trajectory phenotypes of severe eosinophilic asthma on type 2 biologics treatment.The World Allergy Organization journal · 2024Article
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Authors and funding
28 authors at 18 institutions in 7 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is limited evidence on the pathways leading to severe asthma and we are presently unable to effectively predict the progression of the disease. We aimed to describe the longitudinal trajectories leading to severe asthma and to describe clinical events preceding disease progression in a nationwide population of patients with severe asthma.
methodsWe conducted an observational study based on Swedish data from the NORdic Dataset for aSThmA Research (NORDSTAR) research collaboration platform. We identified adult patients with severe asthma in 2018 according to the European Respiratory Society/American Thoracic Society definition and used latent class analysis to identify trajectories of asthma severity over a 10-year retrospective period from 2018.
resultsAmong 169 128 asthma patients, we identified 4543 severe asthma patients. We identified four trajectories of severe asthma that were labelled as: trajectory 1 "consistently severe asthma" (n=389 (8.6%)), trajectory 2 "gradual onset severe asthma" (n=942 (20.7%)), trajectory 3 "intermittent severe asthma" (n=1685 (37.1%)) and trajectory 4 "sudden onset severe asthma" (n=1527 (33.6%)). "Consistently severe asthma" had a higher daily inhaled corticosteroid dose and more prevalent osteoporosis compared with the other trajectories. Patients with "gradual onset severe asthma" and "sudden onset severe asthma" developed type 2-related comorbidities concomitantly with development of severe asthma. In the latter group, this primarily occurred within 1-3 years preceding onset of severe asthma.
conclusionsFour distinct trajectories of severe asthma were identified illustrating different patterns of progression of asthma severity. This may eventually enable the development of better preventive management strategies in severe asthma.
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