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Role of FEF25-75 in managing children with newly-diagnosed asthma in clinical practice

Giorgio Ciprandi1, Maria Angela Tosca2, Irene Schiavetti3

  • 1. gio.cip@libero.it.

Acta Bio-Medica : Atenei Parmensis
|August 31, 2022
PubMed

Insights

In children with asthma, impaired forced expiratory flow rate at 25-75% of vital capacity (FEF25-75) indicates uncontrolled disease, even with normal FEV1. This suggests FEF25-75 is a crucial marker for early asthma detection and management.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Asthma Research

Background:

  • Asthma is characterized by reversible bronchial obstruction.
  • Forced expiratory volume in 1 second (FEV1) is a standard spirometry parameter, but normal FEV1 does not always correlate with asthma control in children.
  • Forced expiratory flow rate at 25-75% of vital capacity (FEF25-75) may detect early airflow impairment.

Purpose of the Study:

  • To investigate the significance of FEF25-75 in children with newly diagnosed asthma.
  • To assess the association between FEF25-75 and asthma control.
  • To evaluate FEF25-75 as a marker for early airflow impairment in pediatric asthma.

Main Methods:

  • A cohort of 381 children with newly diagnosed asthma underwent spirometry, type-2 phenotyping, and asthma control assessment (including Asthma Control Test - ACT).
  • FEF25-75, FVC, and FEV1/FVC ratios were analyzed.
  • Statistical analysis, including odds ratios (OR), was used to determine associations.

Main Results:

  • 18.9% of children had impaired FEF25-75 (<65% of predicted).
  • Impaired FEF25-75 was associated with lower FVC and FEV1/FVC ratios (OR 1.11 and 1.32).
  • Children with normal FEV1 but impaired FEF25-75 showed higher rates of uncontrolled asthma (32.4% vs. 15.8%).

Conclusions:

  • FEF25-75 is a valuable marker in pediatric asthma, particularly for detecting early airflow impairment.
  • Impaired FEF25-75 in children with normal FEV1 suggests a higher likelihood of uncontrolled asthma.
  • Careful consideration of FEF25-75 is warranted for a more comprehensive asthma management approach in children.

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