Asthma and lower airway diseaseForced midexpiratory flow between 25% and 75% of forced vital capacity is associated with long-term persistence of asthma and poor asthma outcomes
Section snippets
Population
The Epidemiological Study on the Genetics and Environment of Asthma (EGEA; https://egeanet.vjf.inserm.fr) is a French cohort including a group of asthmatic patients with their first-degree relatives and a group of control subjects recruited in the early 1990s and followed up for 20 years.17 In total, 2047 adults and children were recruited from 1991 to 1995 (EGEA1). A first follow-up of the EGEA population was conducted from 2003 to 2007 (EGEA2; 1845 subjects),18 and a second follow-up was
Population description
For more information, see Table I. The mean ages of the 142 children (39% girls) and 239 adults (56% women) with current asthma at baseline were 10.8 and 37.6 years, respectively. Among the children, 62.7% had early-onset asthma, and half of the adult population had adult-onset asthma. About half of the adults and one fourth of the children had moderate to severe persistent asthma (as previously defined23). One third of the children and 60% of the adults have used ICSs in the past 12 months.
Discussion
Our analysis in a long-term follow-up cohort is the first to suggest that FEF25-75 values might contribute to the long-term evolution of asthma independently from FEV1. This study adds to the existing evidence that small-airways obstruction warrants greater attention in epidemiologic studies and in the follow-up of asthmatic patients.
One of the strengths of the EGEA relies on the phenotypic characterization of the population, including lung function measurements by trained clinical research
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Data collection and analysis funded in part by the Hospital Program of Clinical Research (PHRC)–Paris, PHRC-Grenoble, National PHRC 2012, the scientific committee “AGIR pour les Maladies Chroniques,” Merck Sharp & Dohme (MSD), and the GA2LEN project (Global Allergy and Asthma European Network).
Disclosure of potential conflict of interest: V. Siroux receives research support from the Hospital Program for Clinical Research and AGIR “pour les Maladies Chroniques” and receives speakers' fees from Edimark Sante and Teva. S. Chanoine receives travel support from Actelion France, GlaxoSmithKline, Chiesi, and LFB. J. Bousquet serves as a consultant for Actelion, Almirall, Meda, Merck, Merck Sharp Dohme, Novartis, Sanofi-Aventis, Takeda, Teva, and Uriach. J. Just serves as a board member for Novartis and ALK-Abelló and receives speakers' fees from Novartis, ALK-Abelló, Stallergenes, and Chiesi. R. Nadif provides expert testimony for Anses and receives research support from the Hospital Program for Clinical Research. C. Pison receives consulting fees and travel support from AstraZeneca France, GlaxoSmithKline France, Novartis France, and Boehringer Ingelheim France. I. Pin receives speakers' fees from GlaxoSmithKline and Novartis and travel support from GlaxoSmithKline, Novartis, and Chiesi. The rest of the authors declare that they have no relevant conflicts of interest.