Severe asthma linked to increased mortality
People with severe asthma have nearly twice the risk of dying prematurely compared to other asthma patients. This is shown in a new study published in the European Respiratory Journal.
Thanks to improved treatments, many people with asthma live good lives. However, for a smaller group—those with severe asthma—the picture is different. A new study within the Nordic research collaboration NORDSTAR, based on data from more than 11,000 patients, shows that the risk of death is significantly higher in this group.
The researchers compared people with severe asthma to those with mild or moderate disease and followed them for up to 20 years. The results show that 34 percent of patients with severe asthma died during the follow-up period, compared with 20 percent in the other group.
"This is one of the largest studies conducted in this field, and it clearly shows that severe asthma is a serious disease", says Apostolos Bossios, researcher at the Institute of Environmental Medicine at Karolinska Institutet.
The increased risk did not only apply to deaths directly linked to asthma. Other diseases, such as cancer and cardiovascular disease, were also more common causes of death among people with severe asthma. At the same time, deaths that could be directly linked to asthma attacks were relatively uncommon.
"We see that comorbidities and recurrent exacerbations are likely driving the risks, rather than the asthma attacks themselves", says Apostolos Bossios.
Severe asthma is estimated to affect 3–8 percent of all asthma patients. The group is characterized by frequent exacerbations, need for hospital care, and multiple coexisting conditions.
The researchers hope the results will contribute to increased awareness of this patient group and lead to better follow-up and treatment.
"Even though asthma treatment has improved enormously, there are still patients who need more targeted interventions", says Apostolos Bossios.
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Publication
Mortality in severe asthma: results from the NORDSTAR cohort
Hansen S, von Bülow A, Cooper A, Sandin P, Ernstsson O, Kankaanranta H, Janson C, Hjoberg J, Lehtimäki L, Bøgvald Aarli B, Geale K, Packham S, Sekulic D, Altraja A, Karjalainen J, Sverrild A, Backer V, Backman H, Kauppi P, Yasinska V, Porsbjerg C, Suppli Ulrik C, Apostolos Bossios.
Eur Respir J. 2026 Mar 5;67(3)
The NORDSTAR-project is a Nordic research collaboration on asthma based on registry data from Denmark, Sweden, Norway, and Finland, covering more than three million people with asthma.
The project enables researchers to follow patients over long periods in order to increase knowledge, particularly about severe asthma, and ultimately improve care and quality of life for patients.
NORDSTAR is led by the Nordic Severe Asthma Network (NSAN), where Apostolos Bossios serves as vice chair.