Uncontrolled Asthma Has a Higher Disease Burden Compared to Controlled Asthma in Adult Onset but Not in Childhood Onset Asthma

Introduction: Adult onset asthma (AA) can develop at any age after the age of 18, in contrast to childhood onset asthma (CA), that develops under the age of 18. Because of ageing in the global population, the prevalence and burden of AA will increase. The aim of this study was to gain insight into the general condition and immunological profiles of AA compared to CA and healthy controls (HC). Methods: This cross-sectional study included 81 adult participants; 25 CA, 27 AA and 29 HC. All completed lung function, blood test for leukocyte differentiation and immune globulin (Ig) profiling, activity tracking and validated questionnaires (ACQ, AQLQ, EQ5D, HADS, PAM and PIH). Data is shown as median (IQR). Results: AA and CA patients were equal in age, gender, education level, T2 inflammation status, corticosteroid use and asthma severity in terms of ACQ and exacerbation frequency. No differences were seen in lung function, blood leukocyte differentiation and Ig profiling. AA scores on AQLQ, EQ5D and HADS were equal to CA. Patients with AA had the same physical activity level as patients with CA. However, AA patients with uncontrolled asthma scored lower on AQLQ (4.6 (4.0;5.5) vs 6.2 (6.0;6.7)), EQ5D (6.0 (5.0;7.5) vs 5.0 (5.0;5.0)), PAM (53.2 (43.2;61.9) vs 76.4 (62.5;90.7)) and PIH (74.0 (69.5;82.0) vs 87.0 (92.3;84.3)) all p<0.01, and higher on HADS (10.0 vs 3.5, p<0.01) compared to AA patients with controlled asthma. This difference was not seen in uncontrolled and controlled patients with CA. Conclusion: AA patients with uncontrolled asthma, and not CA patients, experience worse QoL, experience less self-management abilities and are more prone for depression.