Prevalence and management of severe asthma in the Nordic countries: findings from the NORDSTAR cohort

Susanne Hansen*, Anna von Bülow, Patrik Sandin, Olivia Ernstsson, Christer Janson, Lauri Lehtimäki, Hannu Kankaanranta, Charlotte Ulrik, Bernt Bøgvald Aarli, Hanna Fues Wahl, Kirk Geale, Sheila Tuyet Tang, Maija Wolf, Tom Larsen, Alan Altraja, Helena Backman, Maritta Kilpeläinen, Arja Viinanen, Dora Ludviksdottir, Paula KauppiAsger Sverrild, Sverre Lehmann, Vibeke Backer, Valentyna Yasinska, Tina Skjold, Jussi Karjalainen, Apostolos Bossios, Celeste Porsbjerg

*Corresponding author for this work


BACKGROUND: Real-life evidence on prevalence and management of severe asthma is limited. Nationwide population registries across the Nordic countries provide unique opportunities to describe prevalence and management patterns of severe asthma at population level. In nationwide register data from Sweden, Norway and Finland, we examined the prevalence of severe asthma and the proportion of severe asthma patients being managed in specialist care.

METHODS: This is a cross-sectional study based on the Nordic Dataset for Asthma Research (NORDSTAR) research collaboration platform. We identified patients with severe asthma in adults (aged ≥18 years) and in children (aged 6-17 years) in 2018 according to the European Respiratory Society/American Thoracic Society definition. Patients managed in specialist care were those with an asthma-related specialist outpatient contact (only available in Sweden and Finland).

RESULTS: Overall, we identified 598 242 patients with current asthma in Sweden, Norway and Finland in 2018. Among those, the prevalence of severe asthma was 3.5%, 5.4% and 5.2% in adults and 0.4%, 1.0%, and 0.3% in children in Sweden, Norway and Finland, respectively. In Sweden and Finland, 37% and 40% of adult patients with severe asthma and two or more exacerbations, respectively, were managed in specialist care; in children the numbers were 56% and 41%, respectively.

CONCLUSION: In three Nordic countries, population-based nationwide data demonstrated similar prevalence of severe asthma. In children, severe asthma was a rare condition. Notably, a large proportion of patients with severe asthma were not managed by a respiratory specialist, suggesting the need for increased recognition of severe asthma in primary care.

Original languageEnglish
Article number00687-2022
JournalERJ Open Research
Issue number2
Publication statusPublished - Mar 2023


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