Some comorbid conditions are common and known to impact asthma control in adults, but associations between chronic pain and asthma control in adult-onset asthma are rarely studied.

Our aim was to study associations between chronic pain and asthma control in adult onset asthma.

Postal surveys were performed in population samples from Northern Sweden in 2016. In 2019-2020 participants were invited to clinical follow-ups with e.g. structured interviews and blood sampling. Individuals with adult-onset asthma (n=251) were identified and chronic pain was defined by the question ?Have you ever had chronic pain??. Asthma treatment was classified according to GINA into daily use of step ?3 or step 4-5, and uncontrolled asthma by asthma control test score <20 and/or severe exacerbations last 12m. Adjusted odds ratios (aOR) with chronic pain as dependent variable were estimated by logistic regression.  

The mean age was 63y and 29% had chronic pain. Chronic pain associated with uncontrolled asthma independent of age, sex and pack-years (aOR 2.44, p=0.033). In separate models, chronic pain associated with severe obesity and blood neutrophils ?5 x109/L (aOR 2.95, p=0.015 and aOR 2.92, p=0.004). Still, chronic pain remained associated with uncontrolled asthma also when severe obesity and b-neu ?5 x109/L were included in the model (aOR 1.96, p=0.036). Chronic pain was also more common in GINA step 4-5 treatment compared to GINA?3 (43.5% vs 26.4%, p=0.022). Neither allergic sensitization, FeNO nor blood eosinophils were associated with chronic pain.

In conclusion, our results highlight chronic pain as a common co-existing condition in adult-onset asthma, especially among those with uncontrolled asthma, obesity and increased blood neutrophils