ArticlePediatric pulmonology2025
Asthma Phenotype Progression in Children and Adolescents: A Single Center Experience.
Article in Pediatric pulmonology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAsthma phenotype has implications for presentation and treatment selection.
methodsThis was a retrospective study of patients attending a pediatric pulmonary clinic (2009-2015) with EHR data available for phenotyping (allergic, eosinophilic/non-allergic or non-allergic/non-eosinophilic). Patients were classified by age. A multinomial regression model examined factors associated with phenotype. A logistic regression model examined factors associated with a change in phenotype (present/absent).
resultsThere were 2042 patients included. Approximately 44% of participants were allergic, 17% eosinophilic/non-allergic and 39% non-allergic/non-eosinophilic. Among children 0-4 years, age of asthma onset (aOR 1.42, 95% CI 1.21, 1.65) and mean exacerbations (aOR 1.26 95% CI 1.09, 1.44) were associated with higher odds of an allergic phenotype (vs. non-allergic/non-eosinophilic). Among those aged 5-11 and 12-21, male sex and mild obstruction were positively associated, and age was negatively associated, with an allergic phenotype. Moderate/severe obstruction on spirometry (aOR 6.67, 95% CI 2.00, 22.29) and smoke exposure (aOR 1.77, 95% CI 1.17, 2.67) were also positively associated with an allergic phenotype in patients 12-21 years. Factors positively associated with a change in phenotype included index phenotype (eosinophilic/non-allergic: aOR 5.31, 95% CI 3.46, 8.14) and mean exacerbations (aOR 1.34, 95% CI 1.16, 1.55) (n = 1379). The allergic phenotype was most stable (> 95% predicted probability of remaining allergic); an eosinophilic/non-allergic phenotype had the greatest predicted probability of change (48%).
conclusionsFactors associated with asthma phenotype vary by age. The allergic phenotype was the most stable, while an eosinophilic/non-allergic phenotype was most prone to change.
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