TY - JOUR
T1 - Effect of allergic bronchopulmonary aspergillosis on FEV 1 in children and adolescents with cystic fibrosis
T2 - A European Cystic Fibrosis Society Patient Registry analysis
AU - Kaditis, Athanasios G.
AU - Miligkos, Michael
AU - Bossi, Anna
AU - Colombo, Carla
AU - Hatziagorou, Elpis
AU - Kashirskaya, Nataliya
AU - De Monestrol, Isabelle
AU - Thomas, Muriel
AU - Mei-Zahav, Meir
AU - Chrousos, George
AU - Zolin, Anna
N1 - Publisher Copyright:
© 2017 Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Objective To evaluate the effect of allergic bronchopulmonary aspergillosis (ABPA) on FEV 1 percent predicted in children and adolescents with cystic fibrosis. Design Longitudinal data analysis (2008-2010). Setting Patients participating in the European Cystic Fibrosis Society Patient Registry. Participants 3350 patients aged 6-17 years. Main outcome measure FEV 1 percent predicted was the main outcome measure (one measurement per year per child). To describe the effect of ABPA (main explanatory variable) on FEV 1 while controlling for other prognostic factors, a linear mixed effects regression model was applied. Results In 2008, the mean (±SD) FEV 1 percent predicted was 78.6 (±20.6) in patients with ABPA (n=346) and 88 (±19.8) in those without ABPA (n=2806). After considering other variables, FEV 1 in subjects with ABPA on entry to the study was 1.47 percentage points lower than FEV 1 in patients of similar age without ABPA (p=0.003). There was no FEV 1 decline associated with ABPA over the subsequent study years as the interaction of ABPA with age was not significant (p>0.05). For patients aged 11.82 years (population mean age), poor body mass index had the greatest impact on FEV 1 in 2008, followed by high-risk genotype (two severe mutations), female gender, diabetes mellitus, chronic Pseudomonas aeruginosa infection and ABPA in descending order of effect size. Conclusions In contrast to the common clinical belief of ABPA having a serious impact on lung function, the difference in FEV 1 between young patients with and without the complication was found to be modest when the effect of other prognostic factors was considered.
AB - Objective To evaluate the effect of allergic bronchopulmonary aspergillosis (ABPA) on FEV 1 percent predicted in children and adolescents with cystic fibrosis. Design Longitudinal data analysis (2008-2010). Setting Patients participating in the European Cystic Fibrosis Society Patient Registry. Participants 3350 patients aged 6-17 years. Main outcome measure FEV 1 percent predicted was the main outcome measure (one measurement per year per child). To describe the effect of ABPA (main explanatory variable) on FEV 1 while controlling for other prognostic factors, a linear mixed effects regression model was applied. Results In 2008, the mean (±SD) FEV 1 percent predicted was 78.6 (±20.6) in patients with ABPA (n=346) and 88 (±19.8) in those without ABPA (n=2806). After considering other variables, FEV 1 in subjects with ABPA on entry to the study was 1.47 percentage points lower than FEV 1 in patients of similar age without ABPA (p=0.003). There was no FEV 1 decline associated with ABPA over the subsequent study years as the interaction of ABPA with age was not significant (p>0.05). For patients aged 11.82 years (population mean age), poor body mass index had the greatest impact on FEV 1 in 2008, followed by high-risk genotype (two severe mutations), female gender, diabetes mellitus, chronic Pseudomonas aeruginosa infection and ABPA in descending order of effect size. Conclusions In contrast to the common clinical belief of ABPA having a serious impact on lung function, the difference in FEV 1 between young patients with and without the complication was found to be modest when the effect of other prognostic factors was considered.
KW - allergic bronchopulmonary aspergillosis
KW - cystic fibrosis
KW - lung function
UR - http://www.scopus.com/inward/record.url?scp=85025160988&partnerID=8YFLogxK
U2 - 10.1136/archdischild-2016-311132
DO - 10.1136/archdischild-2016-311132
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C2 - 28325727
AN - SCOPUS:85025160988
SN - 0003-9888
VL - 102
SP - 742
EP - 747
JO - Archives of Disease in Childhood
JF - Archives of Disease in Childhood
IS - 8
ER -