Treatable traits in asthma associated with hospitalizations

Background Personalized medicine targets treatable traits with tailored therapy. Extrapulmonary traits, modifiable and related to asthma, were analyzed for their association with hospitalization rates. Materials and methods We conducted an observational study of a general population cohort in Sweden, based on the Respiratory Health in Northern Europe (RHINE) and Global Allergy and Asthma European Network (GA 2 LEN) studies. Participants completed questionnaires in 2008–2 010, including respiratory symptoms, smoking habits, education level and more. Data was linked with national health registers to obtain information on hospitalizations with asthma. Results Of 31 000 participants, 2341 had current asthma. Asthma patients exhibited a higher prevalence of airway comorbidities, such as rhinitis, allergic rhinitis, and chronic rhinosinusitis, which were associated with increased hospitalization rates. Obesity, insomnia, and snoring were also significant risk factors for hospitalization. A clear trend of increasing hospitalizations was observed with a higher number of treatable traits, especially in asthmatics aged <60 years, who had significantly increased odds of hospitalization when presenting with 3 or more traits (adjusted OR: 1.88, 95% CI: 1.03–3.42). Chronic rhinosinusitis contributed the most to hospitalizations (population attributable fraction (PAF): 10.7%), followed by obesity (PAF: 8.6%). On average, each increase in number of treatable traits was associated with a 13% increased risk of hospitalization (HR: 1.13, 95% CI: 1.02–1.25, p=0.02). Smoking and damp/mould exposure had a negligible contribution to the overall burden of hospitalizations with asthma. Conclusion Recognizing extrapulmonary traits like obesity and chronic rhinosinusitis is vital in asthma management, as they increase the risk of future hospitalizations.