Prognosis and health care consumption for different asthma phenotypes

Research problem and specific questionsLong-term prognosis for adult asthma phenotypes has not been studied before.

The project aims to perform a clinical follow-up of an adult asthma cohort, and to address several scientific objectives, including to identify and characterize clinically relevant adult asthma phenotypes, and to determine prognosis for the different phenotypes in terms of severity, persistence and remission of disease, as well as by register linked outcomes such as mortality, hospitalizations, secondary care utilization, medication use, disability pension and sick leave.

Data and methodData is collected through detailed structured interviews and methods used in clinical practice including measurements of e.g. lung function, along with biomarkers such as IgE sensitization, fractional exhaled NO (FeNO) and peripheral blood cell counts (eosinophils and neutrophils). Linkage to national registers is performed.

Both hypothesis driven and data driven methods such as cluster analysis will be utilized to identify asthma phenotypes and to study their respective prognoses in relation to associations and predictive ability of modifiable risk factors.

Plan for project realisationThe 2023-2025 clinical follow-up: detailed structured interviews, measurements of height and weight, bio impedance, FeNO, pre- and post-bronchodilator spirometry, skin prick testing with a panel of ten common airborne allergens, and blood sampling are performed. All necessary equipment is at place.

Analyzing already collected data: Main applicant and co-applicants as well as PhD students will analyse the already linked clinical and registry data to address the scientific objectives.

The project organization include physicians, nurses, behavioural scientists, epidemiologists, data scientists and statisticians, and there is extensive both multidisciplinary and interdisciplinary expertise within the project organization. RelevanceAsthma is a common disease with about 10% prevalence among adults in the Nordic countries including Sweden.

Large long-term cohort studies enabling estimation of prognosis for different asthma phenotypes are lacking.

Due to the heterogeneity of the disease, knowledge on prognosis for different phenotypes and factors that may impact this prognosis is of major importance not only for efficient resource allocation, but certainly for the concerned patient and the treating nurse or physician, as it will enable secondary prevention and more personalized care.