Ronald L. Sorkness, PhD, Edward M

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Presentation transcript:

Obstruction phenotype as a predictor of asthma severity and instability in children Ronald L. Sorkness, PhD, Edward M. Zoratti, MD, Meyer Kattan, MD, Peter J. Gergen, MD, MPH, Michael D. Evans, MS, Cynthia M. Visness, PhD, Michelle Gill, MD, PhD, Gurjit K. Khurana Hershey, MD, PhD, Carolyn M. Kercsmar, MD, Andrew H. Liu, MD, George T. O'Connor, MD, MS, Jacqueline A. Pongracic, MD, Dinesh Pillai, MD, Christine A. Sorkness, PharmD, Alkis Togias, MD, Robert A. Wood, MD, William W. Busse, MD Journal of Allergy and Clinical Immunology Volume 142, Issue 4, Pages 1090-1099.e4 (October 2018) DOI: 10.1016/j.jaci.2017.09.047 Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 CASI scores, modified to exclude the FEV1 component, are compared for the 3 obstruction phenotypes and expressed as the median and interquartile range for each phenotype. P values for paired comparisons were obtained with Kruskal-Wallis/Conover-Inman tests. Journal of Allergy and Clinical Immunology 2018 142, 1090-1099.e4DOI: (10.1016/j.jaci.2017.09.047) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Asthma treatment step at the final study visit expressed as medians and interquartile ranges for each obstruction phenotype group. P values for paired comparisons were obtained with Kruskal-Wallis/Conover-Inman tests. Journal of Allergy and Clinical Immunology 2018 142, 1090-1099.e4DOI: (10.1016/j.jaci.2017.09.047) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Number of asthma exacerbations during the 12-month study period expressed as the proportion of each group having 0, 1, 2, or 3 or more exacerbations during the study. P values for comparison of numbers of exacerbations between groups were obtained with Kruskal-Wallis/Conover-Inman tests. Journal of Allergy and Clinical Immunology 2018 142, 1090-1099.e4DOI: (10.1016/j.jaci.2017.09.047) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 4 Variability of airway obstruction over multiple study visits expressed as the SD of FEV1 percent predicted measured during the 12-month study period. Medians and interquartile ranges are shown for each obstruction phenotype group. P values for paired comparisons were obtained with Kruskal-Wallis/Conover-Inman tests. Journal of Allergy and Clinical Immunology 2018 142, 1090-1099.e4DOI: (10.1016/j.jaci.2017.09.047) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 5 Methacholine responsiveness was expressed as the median PC20 and interquartile range for each obstruction phenotype group. P values for paired comparisons were obtained with Kruskal-Wallis/Conover-Inman tests. Journal of Allergy and Clinical Immunology 2018 142, 1090-1099.e4DOI: (10.1016/j.jaci.2017.09.047) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E1 Definition of the air-trapping phenotype, change in percent predicted FVC with bronchodilation, and FVC z scores. The dotted line illustrates the cut points defining air-trapping (solid symbols) as the change in percent predicted FVC with bronchodilation (Δ %Prd FVC) of 10 or greater or an FVC z score of less than −1.64. Journal of Allergy and Clinical Immunology 2018 142, 1090-1099.e4DOI: (10.1016/j.jaci.2017.09.047) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E2 Residual lung volume as a fraction of total lung capacity is shown as the median and interquartile range for the None (n = 123), A Limit (n = 67), and A Trpg (n = 26) obstruction phenotype groups. P values for paired comparisons were obtained with Kruskal-Wallis/Conover-Inman tests. RV/TLC, Residual volume/total lung capacity. Journal of Allergy and Clinical Immunology 2018 142, 1090-1099.e4DOI: (10.1016/j.jaci.2017.09.047) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E3 FEF25-75 versus FEV1/FVC z scores in subjects with (red circles) and without (black circles) air-trapping. Solid red and black lines show linear regressions for the respective groups. Broken lines show lower limits of normal for FEV1/FVC (vertical lines) and FEF25-75 (horizontal lines) z scores. Journal of Allergy and Clinical Immunology 2018 142, 1090-1099.e4DOI: (10.1016/j.jaci.2017.09.047) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions