TY - JOUR
T1 - Profiling Persistent Asthma Phenotypes in Adolescents
T2 - A Longitudinal Diagnostic Evaluation from the INSPIRERS Studies
AU - Amaral, Rita
AU - Jácome, Cristina
AU - Almeida, Rute
AU - Pereira, Ana Margarida
AU - Alves-Correia, Magna
AU - Mendes, Sandra
AU - Rodrigues, José Carlos Cidrais
AU - Carvalho, Joana
AU - Araújo, Luís
AU - Costa, Alberto
AU - Silva, Armandina
AU - Teixeira, Maria Fernanda
AU - Ferreira-Magalhães, Manuel
AU - Alves, Rodrigo Rodrigues
AU - Moreira, Ana Sofia
AU - Fernandes, Ricardo M
AU - Ferreira, Rosário
AU - Pinto, Paula Leiria
AU - Neuparth, Nuno
AU - Bordalo, Diana
AU - Bom, Ana Todo
AU - Cálix, Maria José
AU - Ferreira, Tânia
AU - Gomes, Joana
AU - Vidal, Carmen
AU - Mendes, Ana
AU - Vasconcelos, Maria João
AU - Silva, Pedro Morais
AU - Ferraz, José
AU - Morête, Ana
AU - Pinto, Claúdia Sofia
AU - Santos, Natacha
AU - Loureiro, Claúdia Chaves
AU - Arrobas, Ana
AU - Marques, Maria Luís
AU - Lozoya, Carlos
AU - Lopes, Cristina
AU - Cardia, Francisca
AU - Loureiro, Carla Chaves
AU - Câmara, Raquel
AU - Vieira, Inês
AU - Silva, Sofia da
AU - Silva, Eurico
AU - Rodrigues, Natalina
AU - Fonseca, João A
N1 - Funding: This research was funded by ERDF (European Regional Development Fund) through the operations: POCI-01-0145-36 FEDER-029130 (“mINSPIRE—mHealth to measure and improve adherence to medication in chronic respiratory diseases—generalisation and evaluation of gamification, peer support and advanced image processing technologies”) cofunded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).
PY - 2021/1/24
Y1 - 2021/1/24
N2 - We aimed to identify persistent asthma phenotypes among adolescents and to evaluate longitudinally asthma-related outcomes across phenotypes. Adolescents (13-17 years) from the prospective, observational, and multicenter INSPIRERS studies, conducted in Portugal and Spain, were included (n = 162). Latent class analysis was applied to demographic, environmental, and clinical variables, collected at a baseline medical visit. Longitudinal differences in clinical variables were assessed at a 4-month follow-up telephone contact (n = 128). Three classes/phenotypes of persistent asthma were identified. Adolescents in class 1 (n = 87) were highly symptomatic at baseline and presented the highest number of unscheduled healthcare visits per month and exacerbations per month, both at baseline and follow-up. Class 2 (n = 32) was characterized by female predominance, more frequent obesity, and uncontrolled upper/lower airways symptoms at baseline. At follow-up, there was a significant increase in the proportion of controlled lower airway symptoms (p < 0.001). Class 3 (n = 43) included mostly males with controlled lower airways symptoms; at follow-up, while keeping symptom control, there was a significant increase in exacerbations/month (p = 0.015). We have identified distinct phenotypes of persistent asthma in adolescents with different patterns in longitudinal asthma-related outcomes, supporting the importance of profiling asthma phenotypes in predicting disease outcomes that might inform targeted interventions and reduce future risk.
AB - We aimed to identify persistent asthma phenotypes among adolescents and to evaluate longitudinally asthma-related outcomes across phenotypes. Adolescents (13-17 years) from the prospective, observational, and multicenter INSPIRERS studies, conducted in Portugal and Spain, were included (n = 162). Latent class analysis was applied to demographic, environmental, and clinical variables, collected at a baseline medical visit. Longitudinal differences in clinical variables were assessed at a 4-month follow-up telephone contact (n = 128). Three classes/phenotypes of persistent asthma were identified. Adolescents in class 1 (n = 87) were highly symptomatic at baseline and presented the highest number of unscheduled healthcare visits per month and exacerbations per month, both at baseline and follow-up. Class 2 (n = 32) was characterized by female predominance, more frequent obesity, and uncontrolled upper/lower airways symptoms at baseline. At follow-up, there was a significant increase in the proportion of controlled lower airway symptoms (p < 0.001). Class 3 (n = 43) included mostly males with controlled lower airways symptoms; at follow-up, while keeping symptom control, there was a significant increase in exacerbations/month (p = 0.015). We have identified distinct phenotypes of persistent asthma in adolescents with different patterns in longitudinal asthma-related outcomes, supporting the importance of profiling asthma phenotypes in predicting disease outcomes that might inform targeted interventions and reduce future risk.
KW - asthma
KW - adolescents
KW - phenotypes
KW - clustering
KW - longitudinal studies
KW - latent class analysis
U2 - 10.3390/ijerph18031015
DO - 10.3390/ijerph18031015
M3 - Article
C2 - 33498858
SN - 1660-4601
VL - 18
JO - International Journal of Environmental Research and Public Health
JF - International Journal of Environmental Research and Public Health
IS - 3
M1 - 1015
ER -
