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Decline in lung function does not predict future decline in lung function in cystic fibrosis patients.
Margaret Rosenfeld1, Donald R VanDevanter2, Clement L Ren3
1Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington.
Pediatric Pulmonology
|June 19, 2015
Summary
The rate of lung function decline in cystic fibrosis (CF) patients does not predict future decline within or across spirometric variables. However, FEV1 decline moderately predicts future FEV1 levels, impacting CF care.
Area of Science:
- Pulmonary Medicine
- Cystic Fibrosis Research
- Spirometry Analysis
Background:
- Minimizing lung function decline is crucial for cystic fibrosis (CF) patients.
- The predictive impact of lung function decline rate on disease progression remains unclear.
- This study investigates the relationship between spirometric decline rates and future lung function in CF.
Purpose of the Study:
- To describe the rate of decline for FVC, FEV1, and FEF25-75 in CF patients.
- To test if the rate of decline in one spirometric variable predicts the future rate of decline in itself and other variables.
- To assess if FEV1 decline predicts future FEV1 levels.
Main Methods:
- Utilized data from the Epidemiologic Study of CF (1994-2005) with 26,393 patients.
- Calculated 2-year slopes for FVC, FEV1, and FEF25-75 for each patient by age.
- Performed Pearson correlations between initial slopes and subsequent slopes/levels up to 8 years later.
Main Results:
- Median 2-year spirometric slopes were negative for CF patients over 6 years old, with greatest decline in 13-17 year olds.
- No significant correlation was found between initial spirometric slopes and subsequent slopes 3-8 years later.
- A moderate correlation (0.37-0.49) existed between 2-year FEV1 slopes and subsequent FEV1 levels up to 5 years later.
Conclusions:
- The rate of lung function decline in CF does not predict future decline rates within or across spirometric measures.
- FEV1 decline rate shows moderate predictive power for future FEV1 lung function levels.
- Findings have implications for clinical management and clinical trial design in CF care.
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