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RESEARCH PRODUCT

Late-asthma onset and associated factors

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description

Although asthma is usually considered to originate in childhood, adult-onset is being increasingly reported. Aim: to assess factors associated to early- (<18 yrs) and late-onset (≥18 yrs) asthma. Methods: Data from a web-based Italian severe/uncontrolled asthma (SUA) registry (released in 2014), including 577 SUA subjects from 6 clinical and epidemiological Italian centres (Pisa1, Perugia, Ancona, Verona, Palermo, Pisa2). Results: 77.5% of SUA subjects had a late-onset asthma. Among subjects with early-onset asthma there were higher frequencies of allergic asthma (92.1 vs 76.4%), asthma familiarity (52.8 vs 42.8%), seasonal symptoms (51.3 vs 27.6%), active smoking habits (8.5 vs 4.4%) and urban area living (89.9 vs 70.0%), with respect to late-onset asthma. Conversely, among the latter there were higher frequencies of past smoking habits (36.8 vs 26.9%), dust/fume/gas work exposure (35.7 vs 26.1%), occupational asthma diagnosis (6.1vs 0.9%), obesity/overweight (66.1 vs 48.1%), as well as drugs use (94.2 vs 83.8%) and comorbidities (93.4 vs 86.9%). A multivariate logistic regression model showed that late-onset asthma subjects (with respect to early-onset asthma subjects) had: significantly higher risk of being exposed to dust/fume/gas at work (OR 2.25, 1.11-4.59) and significantly lower risk of living in an urban area (OR 0.31, 0.12-0.82) and having an allergic asthma (OR 0.27, 0.12-0.63). Conclusions: Early-onset asthma is more likely related to atopy and urban living. Late-onset asthma is more likely related to occupational risk factors. These results should be taken into account to elaborate preventive strategies. Supported by: the Italian Medicines Agency (AIFA); an unrestricted grant of Roche.