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- W2766391878 abstract "SESSION TITLE: Pediatrics SESSION TYPE: Original Investigation Slide PRESENTED ON: Sunday, October 29, 2017 at 03:15 PM - 04:15 PM PURPOSE: Impaired lung function at baseline and male sex predict subsequent lung function decline after adolescence in children with mild to moderate asthma. This study examined factors associated with lung function decline in a large cohort of adolescents and children with severe asthma. METHODS: Children (aged 6-11 years; n=637) and adolescents (aged 12-17 years; n=627) with severe asthma from The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) study had annual pre- and post-bronchodilator (BD) spirometry for 2 years, interpreted using Global Lung Initiative reference standards. Baseline lung function and changes from baseline at 12 and 24 months were compared by sex, white vs. non-white race, obesity (BMI ≥95%), and exacerbation history (ER admission, hospitalization, or prednisone burst in the past 3 months). RESULTS: Children: Female children were more likely than males to be hospitalized (14% vs. 8%), but males had slightly lower pre-BD FEV1/FVC% at baseline. Non-white children were more likely to have urban residence (81% vs. 62%), higher mean BMI (77th vs. 68th percentile), longer mean duration of asthma (6.6 vs. 5.7 years), greater exacerbation frequency, and lower pre- and post-BD FEV1/FVC% at baseline, 12 months, and 24 months than white children. Obese children had almost 2-fold greater hospitalizations (15% vs. 8%) and lower FEV1/FVC%, but higher FVC%, than non-obese children. Pre-BD FEV1% declined 2% in children, but this was not differentiated by sex, race, or obesity. Adolescents: In adolescents, sex was not an important determinant of exacerbations, lung function, or lung function decline. Non-white adolescents were more likely to be male (67% vs. 54%) and obese (38% vs. 23%), and had significantly more exacerbations with lower pre-BD FEV1% and pre- and post-BD FEV1/FVC% at baseline than white adolescents. Obese adolescents were more likely to be non-white (47% vs. 31%) and had more exacerbations and a higher post-BD FVC% than non-obese adolescents. Pre-BD FEV1% and FVC% declined from baseline to 24 months by 1.7% and 1.3%, respectively, in adolescents, and this decline was significantly greater in non-white versus white adolescents. By contrast, post-BD FEV1% and FVC% declined from baseline to 24 months by 0.4% and 0.7%, respectively—a change that was over 4-fold greater in obese vs. non-obese adolescents. CONCLUSIONS: In children with severe asthma, pre-BD FEV1% declined by approximately 2% over 2 years, but was not informed by sex, race, or obesity. In adolescents with severe asthma, different factors associated with lung function decline when measured as pre- versus post-BD: pre-BD lung function decline was significantly associated with non-white race, whereas post-BD lung function decline was associated with obesity. CLINICAL IMPLICATIONS: Potentially modifiable factors—primarily exacerbations and obesity—interact to promote lung function decline in children and adolescents with severe asthma. DISCLOSURE: W. Gerald Teague: Consultant fee, speaker bureau, advisory committee, etc.: Speaker for Genentech/Novartis and TEVA; advisory boards of Genentech/Novartis, TEVA, GSK, Aviragen, and Boehringer, Grant monies (from industry related sources): Investigator-initiated grants from TEVA, Grant monies (from sources other than industry): Grants with the NIH/NHLBI, Other: Endowed Chair from the Ivy Foundation Leonard B. Bacharier: Grant monies (from sources other than industry): Grant support from NIH, Consultant fee, speaker bureau, advisory committee, etc.: Consultant to Aerocrine, GlaxoSmithKline, Genentech/Novartis, Cephalon, Teva, Circassia, and Boehringer Ingelheim; advisory boards for Merck, Sanofi, and Vectura; data and safety monitoring boards for DBV Technologies; honoraria for lectures or continuing medical education development from Aerocrine, GlaxoSmithKline, Genentech/Novartis, Merck, Cephalon, Teva, AstraZeneca, WebMD/Medscape, and Boehringer Ingelheim Tmirah Haselkorn: Consultant fee, speaker bureau, advisory committee, etc.: Paid consultant to Genentech, Inc. and Novartis Pharmaceuticals Corp. Ahmar Iqbal: Employee: Employee of Genentech, Inc., South San Francisco, CA, USA, Shareholder: Have PFE, GSK stocks David R. Mink: Other: Received funding from Genentech, Inc. through his employer, ICON Clinical Research, for statistical support of the TENOR study Cynthia Alvarez: Other: Received funding from Genentech, Inc. through her employer, ICON Clinical Research, for statistical support of the TENOR study Bradley Chipps: Consultant fee, speaker bureau, advisory committee, etc.: Advisor for Consult & Speakers Bureau for the following companies: AstraZeneca, Boehringer Ingelheim, Circassia, Genentech, Novartis, Teva No Product/Research Disclosure Information" @default.
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- W2766391878 date "2017-10-01" @default.
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- W2766391878 title "Determinants of Lung Function Decline in Children and Adolescents With Severe Asthma" @default.
- W2766391878 doi "https://doi.org/10.1016/j.chest.2017.08.881" @default.
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