Young-Adults (16 25) with Severe Asthma have Worse Outcomes when Compared to Other Age-Groups

Abstract

Background Approximately 800,000 young adults suffer with asthma in the UK.1 Young adulthood can be a challenging time, and living with severe asthma incurs an additional burden, yet little is known about the impact and outcomes of severe asthma in this cohort. Aims To compare data on clinical outcomes from baseline to first annual review of young-adults (16 25) compared to other age groups in the UK-Severe Asthma Registry (UKSAR). Methods Patients in UKSAR, initially seen between January 2015 and October 2023, were included if they had a confirmed severe asthma diagnosis, were >16-years at baseline and had at least one annual review (within 9 24 months of their baseline assessment). Descriptive statistics were calculated using mean with standard deviation, median (interquartile range IQR]) and count (percentage) as appropriate. Results 2,812 patients were included from 25 asthma centres, with age groups categorised (see table 1). Despite having similar exacerbation rates, the young adults were more likely to have attended ED or been admitted to hospital in the previous 12 months, when compared to the older age groups (see table 1). Despite improvements across the cohorts, these differences remained after 12 months in specialist care. Invasive ventilation was most frequently reported among the two younger categories, with 13.2% of 16 25-year-olds and 13.5% of 26 39-year-olds having been intubated, compared to <10% of patients in the older cohorts (p<0.001). The younger age group also had poor asthma control (yet less frequent use of maintenance OCS), higher levels of anxiety and depression, worse adherence and higher FeNO at baseline. Hospital admissions and ED attendance remained significant after adjusted multi-variate analysis, between the young adults and those aged 40 70years. Conclusion In summary, young adults have worse clinical outcomes and biomarkers, when compared to other age groups, with lower levels of adherence and higher levels of anxiety and depression. These outcomes will be driven by multi-factorial causes which require further exploration. This cohort is at an age where health behaviours (adherence and self-management) could be influenced and modified to help improve life-long outcomes and prevent longer-term complications.