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

• Main Author: Amaral, R
• Publication Date: 2021
• Other Authors: Jácome, C, Almeida, R, Pereira, AM, Alves-Correia, M, Mendes, S, Rodrigues, JC, Carvalho, J, Araújo, L, Costa, A, Silva, A, Teixeira, MF, Ferreira-Magalhães, M, Alves, RR, Moreira, AS, Fernandes, RM, Ferreira, R, Leiria-Pinto, P, Neuparth, N, Bordalo, D, Todo Bom, A, Cálix, MJ, Ferreira, T, Gomes, J, Vidal, C, Mendes, A, Vasconcelos, MJ, Silva, PM, Ferraz, J, Morête, A, Pinto, CS, Santos, N, Loureiro, CC, Arrobas, A, Marques, ML, Lozoya, C, Lopes, C, Cardia, F, Câmara, R, Vieira, I, Silva, S, Silva, E, Rodrigues, N, Fonseca, JA
• Format: Article
• Language: eng
• Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
• Download full: http://hdl.handle.net/10400.17/3752
• topic: Adolescent; Female; Humans; Male; Phenotype; Portugal; Prospective Studies; Spain; Asthma; HDE ALER

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.