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

Rita Amaral, Cristina Jácome, Rute Almeida, Ana Margarida Pereira, Magna Alves-Correia, Sandra Mendes, José Carlos Cidrais Rodrigues, Joana Carvalho, Luís Araújo, Alberto Costa, Armandina Silva, Maria Fernanda Teixeira, Manuel Ferreira-Magalhães, Rodrigo Rodrigues Alves, Ana Sofia Moreira, Ricardo M. Fernandes, Rosário Ferreira, Paula Leiria Pinto, Nuno Neuparth, Diana Bordalo, Ana Todo Bom, Maria José Cálix, Tânia Ferreira, Joana Gomes, Carmen Vidal, Ana Mendes, Maria João Vasconcelos, Pedro Morais Silva, José Ferraz, Ana Morête, Claúdia Sofia Pinto, Natacha Santos, Claúdia Chaves Loureiro, Ana Arrobas, Maria Luís Marques, Carlos Lozoya, Cristina Lopes, Francisca Cardia, Carla Chaves Loureiro, Raquel Câmara, Inês Vieira, Sofia da Silva, Eurico Silva, Natalina Rodrigues and João A. Fonseca
Additional contact information
Rita Amaral: Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
Cristina Jácome: Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
Rute Almeida: Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
Ana Margarida Pereira: Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
Magna Alves-Correia: Allergy Unit, CUF Porto Hospital and Institute, 4100-180 Porto, Portugal
Sandra Mendes: Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
José Carlos Cidrais Rodrigues: Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, 4464-513 Matosinhos, Portugal
Joana Carvalho: Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, 4464-513 Matosinhos, Portugal
Luís Araújo: Allergy Unit, CUF Porto Hospital and Institute, 4100-180 Porto, Portugal
Alberto Costa: Serviço de Pediatria, Hospital Senhora da Oliveira, 4835-044 Guimarães, Portugal
Armandina Silva: Serviço de Pediatria, Hospital Senhora da Oliveira, 4835-044 Guimarães, Portugal
Maria Fernanda Teixeira: Serviço de Pediatria, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, 4099-001 Porto, Portugal
Manuel Ferreira-Magalhães: Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
Rodrigo Rodrigues Alves: Serviço de Imunoalergologia, Hospital do Divino Espírito Santo, 9500-370 Ponta Delgada, Portugal
Ana Sofia Moreira: Unidade de Imunoalergologia, Hospital do Divino Espírito Santo, 9500-370 Ponta Delgada, Portugal
Ricardo M. Fernandes: Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, 1649-035 Lisboa, Portugal
Rosário Ferreira: Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, 1649-035 Lisboa, Portugal
Paula Leiria Pinto: Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, 1150-199 Lisboa, Portugal
Nuno Neuparth: Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, 1150-199 Lisboa, Portugal
Diana Bordalo: Serviço de Pediatria, Unidade Hospitalar de Famalicão, Centro Hospitalar do Médio Ave, 4780-371 Vila Nova de Famalicão, Portugal
Ana Todo Bom: Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal
Maria José Cálix: Serviço de Pediatria, Hospital de São Teotónio, Centro Hospitalar Tondela–Viseu, 3504-509 Viseu, Portugal
Tânia Ferreira: Unidade de Saúde Familiar Progresso e Saúde, ACeS Baixo Mondego, 3060-716 Tocha, Portugal
Joana Gomes: Serviço de Imunoalergologia, Unidade I, Centro Hospitalar Vila Nova de Gaia/Espinho, 4434-502 Vila Nova de Gaia, Portugal
Carmen Vidal: Servicio de Alergia, Complejo Hospitalario Universitario de Santiago, 15706 Santiago De Compostela, Spain
Ana Mendes: Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, 1649-035 Lisboa, Portugal
Maria João Vasconcelos: Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, 4200–319 Porto, Portugal
Pedro Morais Silva: Imunoalergologia, Grupo HPA Saúde, 8500-322 Portimão, Portugal
José Ferraz: Imunoalergologia, Hospital Privado de Alfena, Trofa Saúde, 4445-243 Alfena, Portugal
Ana Morête: Serviço de Imunoalergologia, Hospital Infante D. Pedro, Centro Hospitalar Baixo Vouga, 3814-501 Aveiro, Portugal
Claúdia Sofia Pinto: Serviço de Pneumologia, Hospital São Pedro de Vila Real, Centro Hospitalar De Trás-Os-Montes E Alto Douro, 5000-508 Vila Real, Portugal
Natacha Santos: Serviço de Imunoalergologia, Centro Hospitalar Universitário do Algarve, 8000-386 Portimão, Portugal
Claúdia Chaves Loureiro: Serviço de Pneumologia, Hospitais da Universidade de Coimbra, 3000-076 Coimbra, Portugal
Ana Arrobas: Serviço de Pneumologia, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal
Maria Luís Marques: Serviço de Imunoalergologia, Centro Hospitalar Universitário do Porto, 4099-001 Porto, Portugal
Carlos Lozoya: Serviço de Imunoalergologia, Hospital Amato Lusitano, Unidade Local de Saúde de Castelo Branco, 6000-085 Castelo Branco, Portugal
Cristina Lopes: Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, 4464-513 Matosinhos, Portugal
Francisca Cardia: Unidade de Saúde Familiar Terras de Azurara, ACES Dão Lafões, 3530-113 Mangualde, Portugal
Carla Chaves Loureiro: Departamento de Pediatria, Serviço de Pediatria Ambulatória, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal
Raquel Câmara: Serviço de Pneumologia, Hospital Nossa Senhora do Rosário, Centro Hospitalar Barreiro Montijo, 2834-003 Barreiro, Portugal
Inês Vieira: UCSP Dr. Arnaldo Sampaio, ACES Pinhal Litoral, 2419-014 Leiria, Portugal
Sofia da Silva: USF Cuidarte, Unidade Local de Saúde do Alto Minho, 4925-083 Portuzelo, Portugal
Eurico Silva: Unidade de Saúde Familiar João Semana, ACeS Baixo Vouga, 3880-225 Ovar, Portugal
Natalina Rodrigues: Unidade de Saúde Familiar Mondego, ACES Baixo Mondego, 3045-059 Coimbra, Portugal
João A. Fonseca: Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal

IJERPH, 2021, vol. 18, issue 3, 1-11

Abstract: 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.

Keywords: asthma; adolescents; phenotypes; clustering; longitudinal studies; latent class analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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