Asthma and rhinitis control in adolescents and young adults: A real-world MASK-air study

Bernardo Sousa-Pinto; Arunas Valiulis; Erik Melén; Gerard H Koppelman; Nikolaos G Papadopoulos; Mika Makela; Tari Haahtela; Matteo Bonini; Fulvio Braido; Luisa Brussino; Alvaro A Cruz; Alessandro Fiocchi; Mattia Giovannini; Bilun Gemicioglu; Marek Kulus; Piotr Kuna; Maciej Kupczyk; Violeta Kvedariene; Désirée E Larenas-Linnemann; Renaud Louis; Mario Morais-Almeida; Marek Niedoszytko; Markus Ollert; Oliver Pfaar; Frederico S Regateiro; Graham Roberts; Boleslaw Samolinski; Marine Savouré; Luis Taborda-Barata; Sanna Toppila-Salmi; Maria Teresa Ventura; Marta Vazquez-Ortiz; Rafael José Vieira; Joao A Fonseca; Arzu Yorgancioglu; Torsten Zuberbier; Josep M Anto; Jean Bousquet; Nhân Pham-Thi; MASK-air think tank

doi:10.1111/pai.14080

Asthma and rhinitis control in adolescents and young adults: A real-world MASK-air study

Pediatr Allergy Immunol. 2024 Feb;35(2):e14080. doi: 10.1111/pai.14080.

Authors

Bernardo Sousa-Pinto^{1

2}, Arunas Valiulis^{3

4}, Erik Melén^{5

6}, Gerard H Koppelman⁷, Nikolaos G Papadopoulos⁸, Mika Makela⁹, Tari Haahtela⁹, Matteo Bonini^{10

11

12}, Fulvio Braido^{13

14}, Luisa Brussino^{15

16}, Alvaro A Cruz¹⁷, Alessandro Fiocchi¹⁸, Mattia Giovannini^{19

20}, Bilun Gemicioglu²¹, Marek Kulus²², Piotr Kuna²³, Maciej Kupczyk²³, Violeta Kvedariene^{24

25}, Désirée E Larenas-Linnemann²⁶, Renaud Louis^{27

28}, Mario Morais-Almeida²⁹, Marek Niedoszytko³⁰, Markus Ollert^{31

32}, Oliver Pfaar³³, Frederico S Regateiro^{34

35

36}, Graham Roberts^{37

38

39}, Boleslaw Samolinski⁴⁰, Marine Savouré^{41

42}, Luis Taborda-Barata^{36

43}, Sanna Toppila-Salmi^{44

45}, Maria Teresa Ventura^{46

47}, Marta Vazquez-Ortiz^{48

49}, Rafael José Vieira^{1

2}, Joao A Fonseca^{1

2}, Arzu Yorgancioglu⁵⁰, Torsten Zuberbier^{51

52}, Josep M Anto^{53

54

55}, Jean Bousquet^{51

52

56}, Nhân Pham-Thi^{57

58

59}; MASK-air think tank

Affiliations

¹ MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
² CINTESIS@RISE - Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal.
³ Interdisciplinary Research Group of Human Ecology, Institute of Clinical Medicine and Institute of Health Sciences, Medical Faculty of Vilnius University, Vilnius, Lithuania.
⁴ European Academy of Paediatrics, (EAP/UEMS-SP), Brussels, Belgium.
⁵ Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
⁶ Sach's Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.
⁷ Beatrix Children's Hospital, Department of Pediatric Pulmonology and Pediatric Allergology, GRIACResearch Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
⁸ Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
⁹ Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland.
¹⁰ Department of Cardiovascular and Respiratory Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy.
¹¹ Department of Neurological, ENT and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli - IRCCS, Rome, Italy.
¹² National Heart and Lung Institute (NHLI), Imperial College London, London, UK.
¹³ Respiratory Clinic, Department of Internal Medicine, University of Genoa, Genoa, Italy.
¹⁴ IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
¹⁵ Department of Medical Sciences, University of Torino, Torino, Italy.
¹⁶ Allergy and Clinical Immunology Unit, Mauriziano Hospital, Torino, Italy.
¹⁷ Fundaçao ProAR, Federal University of Bahia and GARD/WHO Planning Group, Salvador, Bahia, Brazil.
¹⁸ Allergy, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy.
¹⁹ Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy.
²⁰ Department of Health Sciences, University of Florence, Florence, Italy.
²¹ Department of Pulmonary Diseases, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey.
²² Department of Pediatric Respiratory Diseases and Allergology, Medical University of Warsaw, Warsaw, Poland.
²³ Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.
²⁴ Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
²⁵ Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
²⁶ Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico.
²⁷ Department of Pulmonary Medicine, CHU Liège, Liège, Belgium.
²⁸ GIGA I3 Research Group, University of Liège, Liège, Belgium.
²⁹ Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal.
³⁰ Department of Allergology, Medical University of Gdańsk, Gdansk, Poland.
³¹ Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.
³² Department of Dermatology and Allergy Centre, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark.
³³ Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany.
³⁴ Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Institute of Immunology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
³⁵ Center for Innovative Biomedicine and Biotechnology (CIBB), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
³⁶ UBIAir - Clinical & Experimental Lung Centre and CICS-UBI Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.
³⁷ Faculty of Medicine, University of Southampton, Southampton, UK.
³⁸ The David Hide Asthma and Allergy Centre, St Mary's Hospital, Isle of Wight, UK.
³⁹ NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
⁴⁰ Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland.
⁴¹ Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Villejuif, France.
⁴² Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France.
⁴³ Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal.
⁴⁴ Department of Otorhinolaryngology, Kuopio University Hospital and University of Eastern Finland, Kupio, Finland.
⁴⁵ Department of Allergy, Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
⁴⁶ Allergy and Clinical Immunology, University of Bari Medical School, Bari, Italy.
⁴⁷ Institute of Sciences of Food Production, National Research Council (ISPA-CNR), Bari, Italy.
⁴⁸ Section of Inflammation, Repair and Development, Imperial College London, National Heart and Lung Institute, London, UK.
⁴⁹ Department of Paediatrics, Imperial College Healthcare NHS Trust, London, UK.
⁵⁰ Department of Pulmonary Diseases, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
⁵¹ Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
⁵² Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.
⁵³ ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain.
⁵⁴ Universitat Pompeu Fabra (UPF), Barcelona, Spain.
⁵⁵ CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
⁵⁶ MASK-air, Montpellier, France.
⁵⁷ Ecole Polytechnique de Palaiseau, Palaiseau, France.
⁵⁸ IRBA (Institut de Recherche Bio-Médicale des Armées), Brétigny sur Orge, France.
⁵⁹ Université Paris Cité, Paris, France.

PMID: 38334246
DOI: 10.1111/pai.14080

Abstract

Background: In allergic rhinitis and asthma, adolescents and young adult patients are likely to differ from older patients. We compared adolescents, young adults and adults on symptoms, control levels, and medication adherence.

Methods: In a cross-sectional study (2015-2022), we assessed European users of the MASK-air mHealth app of three age groups: adolescents (13-18 years), young adults (18-26 years), and adults (>26 years). We compared them on their reported rhinitis and asthma symptoms, use and adherence to rhinitis and asthma treatment and app adherence. Allergy symptoms and control were assessed by means of visual analogue scales (VASs) on rhinitis or asthma, the combined symptom-medication score (CSMS), and the electronic daily control score for asthma (e-DASTHMA). We built multivariable regression models to compare symptoms or medication accounting for potential differences in demographic characteristics and baseline severity.

Results: We assessed 965 adolescent users (15,252 days), 4595 young adults (58,161 days), and 15,154 adult users (258,796 days). Users of all three age groups displayed similar app adherence. In multivariable models, age groups were not found to significantly differ in their adherence to rhinitis or asthma medication. These models also found that adolescents reported lower VAS on global allergy, ocular, and asthma symptoms (as well as lower CSMS) than young adults and adults.

Conclusions: Adolescents reported a better rhinitis and asthma control than young adults and adults, even though similar medication adherence levels were observed across age groups. These results pave the way for future studies on understanding how adolescents control their allergic diseases.

Keywords: adherence; adolescents; allergic rhinitis; asthma; digital health; mHealth; real-world data.

MeSH terms

Adolescent
Asthma* / drug therapy
Asthma* / epidemiology
Cross-Sectional Studies
Humans
Research Design
Rhinitis*
Rhinitis, Allergic*
Young Adult