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Data‐driven adult asthma phenotypes based on clinical characteristics are associated with asthma outcomes twenty years later
Author(s) -
Boudier Anne,
Chanoine Sébastien,
Accordini Simone,
Anto Josep M.,
Basagaña Xavier,
Bousquet Jean,
Demoly Pascal,
GarciaAymerich Judith,
Gormand Frédéric,
Heinrich Joachim,
Janson Christer,
Künzli Nino,
Matran Régis,
Pison Christophe,
Raherison Chantal,
Sunyer Jordi,
Varraso Raphaëlle,
Jarvis Deborah,
Leynaert Bénédicte,
Pin Isabelle,
Siroux Valérie
Publication year - 2019
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/all.13697
Subject(s) - asthma , medicine , epidemiology , cluster (spacecraft) , allergy , pediatrics , immunology , computer science , programming language
Background Research based on cluster analyses led to the identification of particular phenotypes confirming phenotypic heterogeneity of asthma. The long‐term clinical course of asthma phenotypes defined by clustering analysis remains unknown, although it is a key aspect to underpin their clinical relevance. We aimed to estimate risk of poor asthma events between asthma clusters identified 20 years earlier. Methods The study relied on two cohorts of adults with asthma with 20‐year follow‐up, ECRHS (European Community Respiratory Health Survey) and EGEA (Epidemiological study on Genetics and Environment of Asthma). Regression models were used to compare asthma characteristics (current asthma, asthma exacerbations, asthma control, quality of life, and FEV 1 ) at follow‐up and the course of FEV 1 between seven cluster‐based asthma phenotypes identified 20 years earlier. Results The analysis included 1325 adults with ever asthma. For each asthma characteristic assessed at follow‐up, the risk for adverse outcomes differed significantly between the seven asthma clusters identified at baseline. As compared with the mildest asthma phenotype, OR s (95% CI ) for asthma exacerbations varied from 0.9 (0.4 to 2.0) to 4.0 (2.0 to 7.8) and the regression estimates (95% CI ) for FEV 1 % predicted varied from 0.6 (−3.5 to 4.6) to −9.9 (−14.2 to −5.5) between clusters. Change in FEV 1 over time did not differ significantly across clusters. Conclusion Our findings show that the long‐term risk for poor asthma outcomes differed between comprehensive adult asthma phenotypes identified 20 years earlier, and suggest a strong tracking of asthma activity and impaired lung function over time.