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Profiling Persistent Asthma Phenotypes in Adolescents: A Longitudinal Diagnostic Evaluation from the INSPIRERS Studies.

Rita AmaralCristina JácomeRute Alexandra Borges de AlmeidaAna Margarida PereiraMagna Alves-CorreiaSandra MendesJosé Carlos Cidrais RodriguesJoana CarvalhoLuís AraújoAlberto CostaArmandina SilvaMaria Fernanda TeixeiraManuel Ferreira-MagalhãesRodrigo Rodrigues AlvesAna Sofia MoreiraRicardo M FernandesRosario Trindade FerreiraPaula Leiria PintoNuno NeuparthDiana BordaloAna Todo BomMaria José CálixTânia FerreiraJoana GomesCristian Hernández-PérezAna MendesMaria João VasconcelosPedro Morais SilvaJosé FerrazAna MorêteClaúdia Sofia PintoNatacha SantosClaúdia Chaves LoureiroAna ArrobasMaria Luís MarquesCarlos LozoyaCristina LopesFrancisca CardiaCarla Chaves LoureiroRaquel Paulinetti CamaraInês VieiraSofia da SilvaEurico SilvaNatalina RodriguesJoão Almeida Fonseca
Published in: International journal of environmental research and public health (2021)
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.
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