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. 2022 Dec 9;11(24):7309.
doi: 10.3390/jcm11247309.

Different Characteristics and Clinical Outcomes between Early-Onset and Late-Onset Asthma: A Prospective Cohort Study

Bing-Chen Wu  1 , Chiung-Hsin Chang  1 , Yun-Chen Tsai  2 , Tin-Yu Lin  1 , Po-Jui Chang  1 , Chun-Yu Lo  1 , Shu-Min Lin  1   2
Affiliations

Different Characteristics and Clinical Outcomes between Early-Onset and Late-Onset Asthma: A Prospective Cohort Study

Bing-Chen Wu et al. J Clin Med. .

Abstract

Late-onset asthma (LOA) differs from early-onset asthma (EOA) in terms of prognosis and the treatment response because it has a much worse prognosis and a poorer response to standard asthma treatment. This study sought to investigate the characteristics and clinical outcomes of asthma patients with phenotypes distinguished by age at onset and atopy status. We prospectively recruited patients with asthma who were registered in a pay-for-performance program operated by Taiwan’s National Health Insurance Administration (NHIA). These patients received regular outpatient treatment for at least 1 year at every outpatient clinic visit since 2019. Baseline characteristics and clinical outcomes were compared between patients with LOA (≥40 years) and those with EOA (<40 years). Of the consecutive 101 patients with asthma, 21 patients (20.7%) had EOA and 80 (79.3%) had LOA. In the 12-month period, patients with EOA had higher declines in forced expiratory volume in one second (FEV1; −2.1 ± 8.4 vs. 6.8 ± 13.1, % of predicted value, p = 0.037) and forced vital capacity (FVC; −4.6 ± 12.0 vs. 6.1 ± 13.6, % of predicted value, p = 0.023) than patients with LOA. Patients with nonatopic EOA had a significantly higher exacerbation rate at 12 months than patients with nonatopic LOA (50% vs. 11.8%, p = 0.012). Identification of different phenotypes of asthma is important in clinical practice because treatment responses may differ.

Keywords: asthma; atopy; exacerbation.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Study profile: The number of patients enrolled and analyzed in the study.
Figure 2
Figure 2
Change of forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) in patients with early-onset asthma (EOA) and late-onset asthma (LOA) after 12-month treatment in the total cohort (A), patients <65 years old (B), and patients ≥65 years old (C). Boxplots show the median (bar), the first and third quartiles (box), and the 1st and 99th percentiles (whiskers) of the biomarkers level for each asthma status.
Figure 3
Figure 3
Percentage of acute exacerbation (AE), emergency room (ER) visits, and hospitalizations in patients with asthma at baseline and after 12-month treatment.
Figure 4
Figure 4
Percentage of acute exacerbations in early-onset asthma (EOA) and late-onset asthma (LOA) patients with atopic and nonatopic status after 12-month treatment. The baseline percentages of acute exacerbation were similar between EOA and LOA in patients with atopic and non-atopic status.
See this image and copyright information in PMC

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