Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2025
Clustering of patients with severe asthma based on long-term percentage of forced expiratory volume in 1 second (FEV1) changes: Real-world evidence.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lee Youngsoo, Chang Junhyuk, Kim Chungsoo, Lee Eunyoung, Jang Jae-Hyuk, Park Rae Woong, Park Hae-Sim
Аннотация
BACKGROUND: Severe asthma is a heterogeneous disease with variable clinical manifestations and treatment responses. Long-term assessment of lung function trajectories may help define phenotypic and endotypic subgroups.
OBJECTIVE: To identify distinct phenotypic clusters in patients with severe asthma using longitudinal changes in percentage of forced expiratory volume in 1 second (FEV1%) and assess the associated clinical and inflammatory profiles.
METHODS: This single-center, retrospective cohort study analyzed 10-year follow-up data from adult patients with severe asthma. Latent class mixed model analysis was performed using serial FEV1% changes. Baseline characteristics and medication use were compared with analysis of variance and χ2 tests. Linear mixed models assessed longitudinal trends in fractional exhaled nitric oxide (FeNO) levels and blood eosinophil/neutrophil counts.
RESULTS: Altogether, 310 patients (mean age, 44.7 ± 14.4 years; 35.2% were males) were included. The following 3 distinct clusters were identified: group 1 (n = 45) demonstrating a progressive decline in FEV1% despite receiving maintenance therapy (refractory to current treatments); group 2 (n = 211) maintaining stable FEV1% (≥80%); and group 3 (n = 54) demonstrating improvement. Group 1 had higher baseline FeNO and eosinophils than group 2, with eosinophil levels comparable to group 3. Over time, group 1 exhibited persistently elevated FeNO and eosinophil levels than groups 2 and 3, whereas neutrophil and IgE trajectories had no differences. Group 1 also required higher cumulative systemic corticosteroid doses.
CONCLUSION: Three distinct FEV1% trajectories were identified in severe asthma. The treatment-refractory group demonstrated progressive lung function decline despite higher corticosteroid use and persistent T2 inflammation, underscoring the need for biologic therapies than corticosteroid escalation.
OBJECTIVE: To identify distinct phenotypic clusters in patients with severe asthma using longitudinal changes in percentage of forced expiratory volume in 1 second (FEV1%) and assess the associated clinical and inflammatory profiles.
METHODS: This single-center, retrospective cohort study analyzed 10-year follow-up data from adult patients with severe asthma. Latent class mixed model analysis was performed using serial FEV1% changes. Baseline characteristics and medication use were compared with analysis of variance and χ2 tests. Linear mixed models assessed longitudinal trends in fractional exhaled nitric oxide (FeNO) levels and blood eosinophil/neutrophil counts.
RESULTS: Altogether, 310 patients (mean age, 44.7 ± 14.4 years; 35.2% were males) were included. The following 3 distinct clusters were identified: group 1 (n = 45) demonstrating a progressive decline in FEV1% despite receiving maintenance therapy (refractory to current treatments); group 2 (n = 211) maintaining stable FEV1% (≥80%); and group 3 (n = 54) demonstrating improvement. Group 1 had higher baseline FeNO and eosinophils than group 2, with eosinophil levels comparable to group 3. Over time, group 1 exhibited persistently elevated FeNO and eosinophil levels than groups 2 and 3, whereas neutrophil and IgE trajectories had no differences. Group 1 also required higher cumulative systemic corticosteroid doses.
CONCLUSION: Three distinct FEV1% trajectories were identified in severe asthma. The treatment-refractory group demonstrated progressive lung function decline despite higher corticosteroid use and persistent T2 inflammation, underscoring the need for biologic therapies than corticosteroid escalation.