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Boudier, A., Curjuric, I., Basagana, X., Hazgui, H., Anto, J. M., Bousquet, J., Bridevaux, P. O., Dupuis-Lozeron, E., Garcia-Aymerich, J., Heinrich, J., Janson, C., Kunzli, N., Leynaert, B., De Marco, R., Rochat, T., Schindler, C., Varraso, R., Pin, I., Probst-Hensch, N., Sunyer, J., Kauffmann, F., Siroux, V

10 Year-Follow up of Cluster-Based Asthma Phenotypes in Adults. A Pooled Analysis of Three Cohorts

Am.J.Respir.Crit Care Med., 2013, 188, 5, 550, 60, IF: 11.080, PMID: 23777340

Rationale: The temporal stability of adult asthma phenotypes identified using clustering methods has never been addressed. Longitudinal cluster-based methods may provide novel insights in the study of natural history of asthma. Objectives: To compare the stability of cluster-based asthma phenotype structures a decade apart in adults and to address the individuals' phenotypic transition across these asthma phenotypes. Methods: The Latent Transition Analysis (LTA) was applied on longitudinal data (twice 10 years apart) from 3320 adults with asthma who took part in ECRHS (European Community Respiratory Health Survey), SAPALDIA (Swiss cohort study on air pollution and lung disease) or EGEA (Epidemiological study on Genetics and Environment of Asthma). Nine variables covering personal and phenotypic characteristics measured twice 10 years apart were simultaneously considered. Main Results: LTA identifies 7 asthma phenotypes (prevalence range: 8.4% to 20.8%), mainly characterized by the level of asthma symptoms (low, moderate, high), the allergic status and pulmonary function. Phenotypes observed 10 years apart showed strong similarities. The probability of membership in the same asthma phenotype at both times varied across phenotypes from 54% to 88%. Different transition patterns were observed across phenotypes. Transitions towards increased asthma symptoms were more frequently observed among non-allergic phenotypes as compared to allergic phenotypes. Results showed a strong stability of the allergic status over time. Conclusion: Adult asthma phenotypes identified by a clustering approach, 10 years apart, were highly consistent. This study is the first to model the probabilities of transitioning over time between comprehensive asthma phenotypes

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