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Novel Trajectories for Identifying Asthma Phenotypes: A Longitudinal Study in Korean Asthma Cohort, COREA

 So Young Park  ;  Hee Won Jung  ;  Jae Moon Lee  ;  Bomi Shin  ;  Hyo Jung Kim  ;  Min-Hye Kim  ;  Woo-Jung Song  ;  Hyouk-Soo Kwon  ;  Jae-Woo Jung  ;  Sae-Hoon Kim  ;  Heung-Woo Park  ;  An-Soo Jang  ;  Yoon-Seok Chang  ;  You Sook Cho  ;  Young-Joo Cho  ;  Sang-Heon Cho  ;  Byoung Whui Choi  ;  Sungho Won  ;  Taesung Park  ;  Hee-Bom Moon  ;  Changsoo Kim  ;  Tae-Bum Kim 
 Journal of Allergy and Clinical Immunology. In Practice, Vol.7(6) : 1850-1857. e4, 2019 
Journal Title
 Journal of Allergy and Clinical Immunology. In Practice 
Issue Date
BACKGROUND: Unbiased cluster analysis has identified several asthma phenotypes. However, these phenotypes did not consistently predict disease prognosis and reflect temporal variability in airway inflammation. OBJECTIVE: We aimed to identify longitudinal trajectories in terms of pulmonary function parameters and investigated whether the trajectories are associated with prognosis. METHODS: Data were extracted from the Cohort for Reality and Evolution of Adult Asthma in Korea (COREA). Three-year pulmonary function test results were used to apply finite mixture models for group-based trajectory in 486 patients with eligible data set. RESULTS: Two main sets of longitudinal trajectories were identified in terms of FEV1% predicted, and FEV1 variability. In the 4 trajectories determined with FEV1% predicted, the pulmonary function showed a consistent course in 4 stratified levels during 3 years of follow-up, which was associated with unexpected hospital visits and the use of steroid bursts due to exacerbation. The variability in pulmonary function showed 3 different patterns, and we found that higher blood and sputum eosinophil levels were associated with the higher variability in pulmonary function and more exacerbations. CONCLUSIONS: Trajectory analysis is a novel method that provides longitudinal asthma phenotypes and aids in prediction of future risk of exacerbation. Further analysis is needed to validate the usefulness of these trajectories in an independent population.
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Chang Soo(김창수) ORCID logo https://orcid.org/0000-0002-5940-5649
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