LAUSR

Background: Diagnostic criteria of asthma-COPD overlap (ACOS) are under discussion. Recently, it has been suggested that as a criteria for ACOS, asthma should be diagnosed before age 40 years 1 . However, increasing evidence shows that persistent asthma is often diagnosed at older age 2 . Aims: Our aim was to assess the proportion of patients who are diagnosed with persistent asthma before the age of 40 years in Finland, and evaluate the validity and consequences of the suggested age limit. Methods: In Finland every patient with novel persistent asthma is entitled to asthma medication reimbursement by Social Insurance Institution (SII). We obtained the numbers of patients entitled to new asthma medication reimbursement (reflecting the number of new diagnoses of asthma) in Finland during 2012-2013 from the SII, and evaluated at what age the reimbursement was obtained. Results: In Finland, 26,281 new patients were entitled to reimbursement for their asthma medication (13,941 females and 12,340 males) during 2012-2013. Of these, only 12,095 persons (46.0%) belonged to age group of 0-39 years. Majority (54.0%) of the patients were 40 years or older. 57.9% of females were ≥ 40 years when they obtained their reimbursement, whereas every second man (50.5%) was aged Conclusion: Majority of persistent asthma in Finland is diagnosed after 40 years of age. Using the suggested age limit of 40 as a criteria for ACOS may lead to severe underdiagnosing of asthma, especially among women. We propose, that the suggested age limit of asthma-onset should be reconsidered. References: 1. Sin DD, et al. Eur Respir J 2016;48:664-673 2. Kankaanranta H, et al. J Allergy Clin Immunol Pract. 2017;5:189-191