Newly diagnosed asthma in China: initial severity and changes over a 1-year management period

Zhizhen Hu; Jianwei Xuan; Haijin Zhao; Hangming Dong; Changhui Yu; Shaoxi Cai; Yue Gao; Liran Li; Xiaohan Hu

doi:10.21037/atm-21-6470

Newly diagnosed asthma in China: initial severity and changes over a 1-year management period

Ann Transl Med. 2022 Jan;10(2):75. doi: 10.21037/atm-21-6470.

Authors

Zhizhen Hu¹, Jianwei Xuan², Haijin Zhao¹, Hangming Dong¹, Changhui Yu¹, Shaoxi Cai¹, Yue Gao³, Liran Li³, Xiaohan Hu³

Affiliations

¹ Department of Respiratory and Critical Care Medicine, Chronic Airways Diseases Laboratory, Nanfang Hospital, Southern Medical University, Guangzhou, China.
² Health Economic Research Institute, Sun Yat-sen University, Guangzhou, China.
³ Centennial Scientific Co., Ltd., Shanghai, China.

Abstract

Background: There are no large sample, epidemiological data describing initial asthma severity and change. We used a large health care database to examine asthma severity at initial diagnosis, and the changes in severity over the first year of management.

Methods: The clinical data of patients diagnosed with asthma for the first time were collated from the SuValue electronic medical database. The following inclusion criteria were applied: (I) patients who were 14 years or older at the time of first diagnosis; (II) initial diagnosis occurred between Jan 2001 and Mar 2019; (III) patients were followed up for at least 12 months; (IV) patients had follow-up visits every 3 months. Disease severity at diagnosis and at each follow-up visit, medications prescribed were collated and analyzed.

Results: A total of 7,654 adult patients with newly diagnosed asthma from tertiary hospitals (26.38%) and secondary hospitals (73.62%), who were followed up for at least 12 months, were included in this retrospective analysis. Approximately 54% of patients were females and the largest age group was over 60 years old (37.66%). Nearly 16% of patients were moderate to severe asthma initially. The proportions of patients with moderate and severe asthma decreased during the first 6 months, and remained stable thereafter. At the end of the 1-year follow-up period, 2.7% of patients had severe asthma. Patients with mild asthma tended to continue to have mild asthma in the following 3 months (>76.19%). However, of the patients with mild or moderate asthma at 3 months, 92.85% and 75.1%, respectively, experienced maintenance and reduction in severity and had mild asthma by 12 months. 1.26% and 3.15% of patients with mild or moderate asthma, respectively, progressed to severe asthma by 12 months.

Conclusions: Patients with mild asthma did not progress but rather, remained stable with mild asthma over the year. A proportion of patients diagnosed with moderate and severe asthma remained stable over a 1-year period. Further studies should be conducted to examine the clinical features of newly diagnosed patients with severe asthma without reduction in severity in order to facilitate intensive treatment and reduce the disease burden for these patients.

Keywords: Asthma severity; China; new diagnosis; treatment.