Abstract
Background: Recent guidelines have proposed different phenotypes according to triggers (episodic/virus (EVW) and multiple trigger wheeze (MTW)) in preschool children. Studies aimed at characterizing asthma evolution according to these phenotypes are seldom.
Aims: To investigate lung function and asthma evolution up to adulthood between MTW and EVW in childhood.
Methods: 588 children, aged 10.9±3.0 years included in EGEA study were classified as non wheezer (n=265), EVW (wheeze only with viral infections and asymptomatic between episodes, n=131) and MTW (wheeze with viral infections and between episodes with triggers such as dust, tobacco smoke, exercise, and cold air, n=192). 139 (72.4%) MTW and 85 (64.9%) EVW participated to the 12-year follow-up.
Results: At baseline MTW were older (11.5 vs 10.1 years), more atopic (at least 1 positive skin test, 89.7 vs 57.0%), had more often active asthma (symptoms or treatment in the past year, 96.2 vs 58.3%) and ICS use in the past year (54.7 vs 26.4%) compared to EVW. FEV1 and FVC (% pred Stanojevic) were similar in both groups but MTW had lower FEV1/FVC ratio (85.4±7.1vs 88.3±7.0, p= 0.001) and FEF25-75 (93.6±25.5 vs 103.2±26.5%, p=0.002) compared to EVW.
At follow-up MTW had more often active asthma (71.9 vs 38.5%, p=0.003), and ICS use (39.1 vs 18.1%) compared to EVW. FEV1/FVC and FEF25-75 remained lower in MTW than in EVW (81.2±7.6 vs 84.8±7.8%, p=0.002 and 94.6±25.5 vs 110.3±26.8%, p<0.0001 respectively).
Conclusions: Our results suggest that the episodic vs multi-trigger wheeze classification applied in school-age children identified groups of wheezers with different baseline characteristics and long-term evolution.
- © 2011 ERS