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Giorgio Ciprandi - One of the best experts on this subject based on the ideXlab platform.

  • Forced Expiratory Flow between 25 and 75% of vital capacity might be a predictive factor for bronchial hyperreactivity in children with allergic rhinitis, asthma, or both.
    Allergy and asthma proceedings, 2020
    Co-Authors: Giorgio Ciprandi, Mariangela Tosca, Michele Capasso
    Abstract:

    Allergic rhinitis and asthma are closely associated. Bronchial hyperreactivity (BHR) is a pathophysiological characteristic of asthma. Forced Expiratory Flow between 25 and 75% of vital capacity (FEF(25-75)) has been previously shown to be able to predict BHR in adult patients with allergic rhinitis. Therefore, the aim of this study was (i) to evaluate the presence of BHR in a large group of children with allergic rhinitis, asthma or both and (ii) to confirm whether FEF(25-75) might be related to BHR and may predict BHR also in a pediatric population. Nine hundred fifty children with allergic rhinitis (350), asthma (300), or both (300) were enrolled. Clinical examination, skin-prick test, spirometry, and methacholine challenge were performed in all patients. Severe BHR was quite frequent in allergic children, mainly in asthmatic patients. FEF(25-75) values were significantly related to BHR grade, mainly in children with rhinitis (r = 0.69). Impaired FEF(25-75) values (such as ≤65% of predicted) constituted a relevant predictive factor for severe BHR, mainly in children with rhinitis (odds ratio, 8.9). In conclusion, this pediatric study confirmed that impaired FEF(25-75) values might predict severe BHR in children, mainly in those with allergic rhinitis. Therefore, low FEF(25-75) values could suggest BHR in children.

  • The pragmatic role of FEF25-75 in asymptomatic subjects, allergic rhinitis, asthma, and in military setting.
    Expert Review of Respiratory Medicine, 2019
    Co-Authors: Giorgio Ciprandi, Ignazio Cirillo
    Abstract:

    ABSTRACTIntroduction: The Forced Expiratory Flow between 25% and 75% of Forced vital capacity (FEF25-75) is a spirometry parameter that may be useful in many clinical settings. Values

  • A Forced Expiratory Flow at 25-75% value
    Allergy and Asthma Proceedings, 2012
    Co-Authors: Giorgio Ciprandi, Michele Capasso, Mariangela Tosca, Carmelo Salpietro, A. Salpietro, Gian Luigi Marseglia, Mario La Rosa
    Abstract:

    : Forced Expiratory volume in 1 second (FEV1) is considered an important parameter for asthma diagnosis and follow-up. However, it has been proposed that Forced Expiratory Flow at 25-75% (FEF(25-75)) could be more sensitive than FEV1 to detect slight airways obstruction. In this regard, a cutoff FEF(25-75) value has been recently established in a group of asthmatic children: FEF(25-75) < 65% of predicted has been considered impaired. However, the considered population was specifically selected. Therefore, the aim of the present study was to confirm an FEF(25-75) cutoff value in a large cohort of asthmatic children. Seven hundred allergic children (493 male subjects; median age, 11 years) with controlled and partly controlled asthma were evaluated by performing spirometry and skin-prick tests. Three hundred thirteen (44.7%) patients had FEF(25-75%) values of

  • a Forced Expiratory Flow at 25 75 value 65 of predicted should be considered abnormal a real world cross sectional study
    Allergy and Asthma Proceedings, 2012
    Co-Authors: Giorgio Ciprandi, Michele Capasso, Mariangela Tosca, Carmelo Salpietro, A. Salpietro, Gian Luigi Marseglia, Mario La Rosa
    Abstract:

    : Forced Expiratory volume in 1 second (FEV1) is considered an important parameter for asthma diagnosis and follow-up. However, it has been proposed that Forced Expiratory Flow at 25-75% (FEF(25-75)) could be more sensitive than FEV1 to detect slight airways obstruction. In this regard, a cutoff FEF(25-75) value has been recently established in a group of asthmatic children: FEF(25-75) < 65% of predicted has been considered impaired. However, the considered population was specifically selected. Therefore, the aim of the present study was to confirm an FEF(25-75) cutoff value in a large cohort of asthmatic children. Seven hundred allergic children (493 male subjects; median age, 11 years) with controlled and partly controlled asthma were evaluated by performing spirometry and skin-prick tests. Three hundred thirteen (44.7%) patients had FEF(25-75%) values of <65% of predicted. Two predictors were significantly associated with impaired FEF(25-75) values: (i) sensitization to perennial allergens (adjusted odds ratio [OR(Adj)], 3.4) and (ii) FEV(1) ≤ 86% of predicted (OR(Adj), 3.8). This study, conducted in real life, could suggest that FEF(25-75) value of <65% of predicted may be considered abnormal.

  • Forced Expiratory Flow between 25 and 75 of vital capacity might be a predictive factor for bronchial hyperreactivity in children with allergic rhinitis asthma or both
    Allergy and Asthma Proceedings, 2011
    Co-Authors: Giorgio Ciprandi, Mariangela Tosca, Michele Capasso
    Abstract:

    : Allergic rhinitis and asthma are closely associated. Bronchial hyperreactivity (BHR) is a pathophysiological characteristic of asthma. Forced Expiratory Flow between 25 and 75% of vital capacity (FEF(25-75)) has been previously shown to be able to predict BHR in adult patients with allergic rhinitis. Therefore, the aim of this study was (i) to evaluate the presence of BHR in a large group of children with allergic rhinitis, asthma or both and (ii) to confirm whether FEF(25-75) might be related to BHR and may predict BHR also in a pediatric population. Nine hundred fifty children with allergic rhinitis (350), asthma (300), or both (300) were enrolled. Clinical examination, skin-prick test, spirometry, and methacholine challenge were performed in all patients. Severe BHR was quite frequent in allergic children, mainly in asthmatic patients. FEF(25-75) values were significantly related to BHR grade, mainly in children with rhinitis (r = 0.69). Impaired FEF(25-75) values (such as ≤65% of predicted) constituted a relevant predictive factor for severe BHR, mainly in children with rhinitis (odds ratio, 8.9). In conclusion, this pediatric study confirmed that impaired FEF(25-75) values might predict severe BHR in children, mainly in those with allergic rhinitis. Therefore, low FEF(25-75) values could suggest BHR in children.

E Afaneze - One of the best experts on this subject based on the ideXlab platform.

  • clinical significance of low Forced Expiratory Flow between 25 and 75 of vital capacity following treated pulmonary tuberculosis a cross sectional study
    BMJ Open, 2014
    Co-Authors: Eric Walter Pefurayone, Andre Pascal Kengne, Pierre Eugene Tagnekamdem, E Afaneze
    Abstract:

    Objectives The aim of this study was to assess the prevalence and determinants of post-tuberculosis chronic respiratory signs, as well as the clinical impact of a low Forced Expiratory Flow between 25% and 75% (FEF25–75%) in a group of individuals previously treated successfully for pulmonary tuberculosis. Design This was a cross-sectional study involving individuals in their post-tuberculosis treatment period. They all underwent a spirometry following the 2005 criteria of the American Thoracic Society/European Respiratory Society. Distal airFlow obstruction (DAO) was defined by an FEF25–75% <65% and a ratio Forced Expiratory volume during the first second (FEV1)/Forced vital capacity (FVC) ≥ 0.70. Logistic regression models were used to investigate the determinants of persisting respiratory symptoms following antituberculous treatment. Setting This study was carried out in the tuberculosis diagnosis and treatment centre at Yaounde Jamot Hospital, which serves as a referral centre for tuberculosis and respiratory diseases for the capital city of Cameroon (Yaounde) and surrounding areas. Participants All consecutive patients in their post-tuberculosis treatment period were consecutively enrolled between November 2012 and April 2013. Results Of the 177 patients included, 101 (57.1%) were men, whose median age (25th-75th centiles) was 32 (24–45.5) years. At least one chronic respiratory sign was present in 110 (62.1%) participants and DAO was found in 67 (62.9%). Independent determinants of persisting respiratory signs were the duration of symptoms prior to tuberculosis diagnosis higher than 12 weeks (adjusted OR 2.91; 95% CI 1.12 to 7.60, p=0.029) and presence of DAO (2.22; 1.13 to 4.38, p=0.021). Conclusions FEF25–75%<65% is useful for the assessment and diagnosis of post-tuberculous DAO. Mass education targeting early diagnosis of pulmonary tuberculosis can potentially reduce the prevalence of post-tuberculosis respiratory signs and distal airFlow obstruction.

Mariangela Tosca - One of the best experts on this subject based on the ideXlab platform.

  • Forced Expiratory Flow between 25 and 75% of vital capacity might be a predictive factor for bronchial hyperreactivity in children with allergic rhinitis, asthma, or both.
    Allergy and asthma proceedings, 2020
    Co-Authors: Giorgio Ciprandi, Mariangela Tosca, Michele Capasso
    Abstract:

    Allergic rhinitis and asthma are closely associated. Bronchial hyperreactivity (BHR) is a pathophysiological characteristic of asthma. Forced Expiratory Flow between 25 and 75% of vital capacity (FEF(25-75)) has been previously shown to be able to predict BHR in adult patients with allergic rhinitis. Therefore, the aim of this study was (i) to evaluate the presence of BHR in a large group of children with allergic rhinitis, asthma or both and (ii) to confirm whether FEF(25-75) might be related to BHR and may predict BHR also in a pediatric population. Nine hundred fifty children with allergic rhinitis (350), asthma (300), or both (300) were enrolled. Clinical examination, skin-prick test, spirometry, and methacholine challenge were performed in all patients. Severe BHR was quite frequent in allergic children, mainly in asthmatic patients. FEF(25-75) values were significantly related to BHR grade, mainly in children with rhinitis (r = 0.69). Impaired FEF(25-75) values (such as ≤65% of predicted) constituted a relevant predictive factor for severe BHR, mainly in children with rhinitis (odds ratio, 8.9). In conclusion, this pediatric study confirmed that impaired FEF(25-75) values might predict severe BHR in children, mainly in those with allergic rhinitis. Therefore, low FEF(25-75) values could suggest BHR in children.

  • A Forced Expiratory Flow at 25-75% value
    Allergy and Asthma Proceedings, 2012
    Co-Authors: Giorgio Ciprandi, Michele Capasso, Mariangela Tosca, Carmelo Salpietro, A. Salpietro, Gian Luigi Marseglia, Mario La Rosa
    Abstract:

    : Forced Expiratory volume in 1 second (FEV1) is considered an important parameter for asthma diagnosis and follow-up. However, it has been proposed that Forced Expiratory Flow at 25-75% (FEF(25-75)) could be more sensitive than FEV1 to detect slight airways obstruction. In this regard, a cutoff FEF(25-75) value has been recently established in a group of asthmatic children: FEF(25-75) < 65% of predicted has been considered impaired. However, the considered population was specifically selected. Therefore, the aim of the present study was to confirm an FEF(25-75) cutoff value in a large cohort of asthmatic children. Seven hundred allergic children (493 male subjects; median age, 11 years) with controlled and partly controlled asthma were evaluated by performing spirometry and skin-prick tests. Three hundred thirteen (44.7%) patients had FEF(25-75%) values of

  • a Forced Expiratory Flow at 25 75 value 65 of predicted should be considered abnormal a real world cross sectional study
    Allergy and Asthma Proceedings, 2012
    Co-Authors: Giorgio Ciprandi, Michele Capasso, Mariangela Tosca, Carmelo Salpietro, A. Salpietro, Gian Luigi Marseglia, Mario La Rosa
    Abstract:

    : Forced Expiratory volume in 1 second (FEV1) is considered an important parameter for asthma diagnosis and follow-up. However, it has been proposed that Forced Expiratory Flow at 25-75% (FEF(25-75)) could be more sensitive than FEV1 to detect slight airways obstruction. In this regard, a cutoff FEF(25-75) value has been recently established in a group of asthmatic children: FEF(25-75) < 65% of predicted has been considered impaired. However, the considered population was specifically selected. Therefore, the aim of the present study was to confirm an FEF(25-75) cutoff value in a large cohort of asthmatic children. Seven hundred allergic children (493 male subjects; median age, 11 years) with controlled and partly controlled asthma were evaluated by performing spirometry and skin-prick tests. Three hundred thirteen (44.7%) patients had FEF(25-75%) values of <65% of predicted. Two predictors were significantly associated with impaired FEF(25-75) values: (i) sensitization to perennial allergens (adjusted odds ratio [OR(Adj)], 3.4) and (ii) FEV(1) ≤ 86% of predicted (OR(Adj), 3.8). This study, conducted in real life, could suggest that FEF(25-75) value of <65% of predicted may be considered abnormal.

  • Forced Expiratory Flow between 25 and 75 of vital capacity might be a predictive factor for bronchial hyperreactivity in children with allergic rhinitis asthma or both
    Allergy and Asthma Proceedings, 2011
    Co-Authors: Giorgio Ciprandi, Mariangela Tosca, Michele Capasso
    Abstract:

    : Allergic rhinitis and asthma are closely associated. Bronchial hyperreactivity (BHR) is a pathophysiological characteristic of asthma. Forced Expiratory Flow between 25 and 75% of vital capacity (FEF(25-75)) has been previously shown to be able to predict BHR in adult patients with allergic rhinitis. Therefore, the aim of this study was (i) to evaluate the presence of BHR in a large group of children with allergic rhinitis, asthma or both and (ii) to confirm whether FEF(25-75) might be related to BHR and may predict BHR also in a pediatric population. Nine hundred fifty children with allergic rhinitis (350), asthma (300), or both (300) were enrolled. Clinical examination, skin-prick test, spirometry, and methacholine challenge were performed in all patients. Severe BHR was quite frequent in allergic children, mainly in asthmatic patients. FEF(25-75) values were significantly related to BHR grade, mainly in children with rhinitis (r = 0.69). Impaired FEF(25-75) values (such as ≤65% of predicted) constituted a relevant predictive factor for severe BHR, mainly in children with rhinitis (odds ratio, 8.9). In conclusion, this pediatric study confirmed that impaired FEF(25-75) values might predict severe BHR in children, mainly in those with allergic rhinitis. Therefore, low FEF(25-75) values could suggest BHR in children.

  • bronchial hyperreactivity in patients with allergic rhinitis Forced Expiratory Flow between 25 and 75 of vital capacity might be a predictive factor
    Allergy and Asthma Proceedings, 2011
    Co-Authors: Giorgio Ciprandi, Mariangela Tosca, Alessio Signori, Ignazio Cirillo
    Abstract:

    : Allergic rhinitis (AR) is considered a strong risk factor for the onset of asthma. Bronchial hyperreactivity (BHR) may be present in patients with AR. Forced Expiratory Flow between 25 and 75% of vital capacity (FEF(25-75)) may be impaired in AR patients. The aim of this study was to evaluate the presence of BHR in a large group of patients with AR and whether FEF(25-75) might be related to BHR. Four thousand seven hundred eighty-one patients with AR were enrolled. Clinical examination, skin-prick test, spirometry, and methacholine challenge were performed in all patients. Fourteen percent of patients had severe BHR and 25.3% had mild BHR. Patients with low FEF(25-75) values (such as ≤65% of predicted) had severe BHR more frequently than patients with normal FEF(25-75) values (p < 0.001). In addition, low FEF(25-75) values constitute a relevant predictive factor (OR = 12.9) for severe BHR. This study shows that a relevant percentage of AR patients had BHR, and impaired FEF(25-75) values might predict it. Therefore, BHR should be suspected in AR patients with low FEF(25-75) values.

Ignazio Cirillo - One of the best experts on this subject based on the ideXlab platform.

  • The pragmatic role of FEF25-75 in asymptomatic subjects, allergic rhinitis, asthma, and in military setting.
    Expert Review of Respiratory Medicine, 2019
    Co-Authors: Giorgio Ciprandi, Ignazio Cirillo
    Abstract:

    ABSTRACTIntroduction: The Forced Expiratory Flow between 25% and 75% of Forced vital capacity (FEF25-75) is a spirometry parameter that may be useful in many clinical settings. Values

  • Bronchial hyperreactivity in patients with allergic rhinitis: Forced Expiratory Flow between 25 and 75% of vital capacity might be a predictive factor.
    Allergy and Asthma Proceedings, 2011
    Co-Authors: Giorgio Ciprandi, Mariangela Tosca, Alessio Signori, Ignazio Cirillo
    Abstract:

    : Allergic rhinitis (AR) is considered a strong risk factor for the onset of asthma. Bronchial hyperreactivity (BHR) may be present in patients with AR. Forced Expiratory Flow between 25 and 75% of vital capacity (FEF(25-75)) may be impaired in AR patients. The aim of this study was to evaluate the presence of BHR in a large group of patients with AR and whether FEF(25-75) might be related to BHR. Four thousand seven hundred eighty-one patients with AR were enrolled. Clinical examination, skin-prick test, spirometry, and methacholine challenge were performed in all patients. Fourteen percent of patients had severe BHR and 25.3% had mild BHR. Patients with low FEF(25-75) values (such as ≤65% of predicted) had severe BHR more frequently than patients with normal FEF(25-75) values (p < 0.001). In addition, low FEF(25-75) values constitute a relevant predictive factor (OR = 12.9) for severe BHR. This study shows that a relevant percentage of AR patients had BHR, and impaired FEF(25-75) values might predict it. Therefore, BHR should be suspected in AR patients with low FEF(25-75) values.

  • bronchial hyperreactivity in patients with allergic rhinitis Forced Expiratory Flow between 25 and 75 of vital capacity might be a predictive factor
    Allergy and Asthma Proceedings, 2011
    Co-Authors: Giorgio Ciprandi, Mariangela Tosca, Alessio Signori, Ignazio Cirillo
    Abstract:

    : Allergic rhinitis (AR) is considered a strong risk factor for the onset of asthma. Bronchial hyperreactivity (BHR) may be present in patients with AR. Forced Expiratory Flow between 25 and 75% of vital capacity (FEF(25-75)) may be impaired in AR patients. The aim of this study was to evaluate the presence of BHR in a large group of patients with AR and whether FEF(25-75) might be related to BHR. Four thousand seven hundred eighty-one patients with AR were enrolled. Clinical examination, skin-prick test, spirometry, and methacholine challenge were performed in all patients. Fourteen percent of patients had severe BHR and 25.3% had mild BHR. Patients with low FEF(25-75) values (such as ≤65% of predicted) had severe BHR more frequently than patients with normal FEF(25-75) values (p < 0.001). In addition, low FEF(25-75) values constitute a relevant predictive factor (OR = 12.9) for severe BHR. This study shows that a relevant percentage of AR patients had BHR, and impaired FEF(25-75) values might predict it. Therefore, BHR should be suspected in AR patients with low FEF(25-75) values.

  • Role of Forced Expiratory Flow at 25-75% as an early marker of small airways impairment in subjects with allergic rhinitis.
    Allergy and Asthma Proceedings, 2007
    Co-Authors: Gian Luigi Marseglia, Mariangela Tosca, Mario La Rosa, Ignazio Cirillo, Andrea Vizzaccaro, Catherine Klersy, Alessia Marseglia, Amelia Licari, M. Leone, Giorgio Ciprandi
    Abstract:

    A close link exists between allergic rhinitis and asthma. Small airway disease (SAD), defined by a reduction in Forced Expiratory Flow at 25-75% of the pulmonary volume (FEF 25-75 ) and normal spirometry (normal Forced Expiratory volume at 1 second [FEV 1 ], Forced vital capacity [FVC], and FEV 1 /FVC ratio), may be a marker for early allergic or inflammatory involvement of the small airways in subjects with allergic diseases and no asthma. The aim of this study was to determine if there is a relationship between SAD, the outcome variable, and several allergic predictors in patients without asthma but with allergic rhinitis. A cross-sectional study was performed. Two hundred eleven midshipmen attending the third and fifth course of the Navy Academy of Livorno were screened. Fifty-eight midshipmen showed slight spirometric anomalies. Thus, they were referred to the Navy Hospital of La Spezia for standardized tests: skin-prick test, nasal cytology, spirometry, and methacholine bronchial challenge. A reduced FEF 25-75 was arbitrarily defined as

  • role of Forced Expiratory Flow at 25 75 as an early marker of small airways impairment in subjects with allergic rhinitis
    Allergy and Asthma Proceedings, 2007
    Co-Authors: Gian Luigi Marseglia, Mariangela Tosca, Mario La Rosa, Ignazio Cirillo, Andrea Vizzaccaro, Catherine Klersy, Alessia Marseglia, Amelia Licari, M. Leone, Giorgio Ciprandi
    Abstract:

    A close link exists between allergic rhinitis and asthma. Small airway disease (SAD), defined by a reduction in Forced Expiratory Flow at 25-75% of the pulmonary volume (FEF 25-75 ) and normal spirometry (normal Forced Expiratory volume at 1 second [FEV 1 ], Forced vital capacity [FVC], and FEV 1 /FVC ratio), may be a marker for early allergic or inflammatory involvement of the small airways in subjects with allergic diseases and no asthma. The aim of this study was to determine if there is a relationship between SAD, the outcome variable, and several allergic predictors in patients without asthma but with allergic rhinitis. A cross-sectional study was performed. Two hundred eleven midshipmen attending the third and fifth course of the Navy Academy of Livorno were screened. Fifty-eight midshipmen showed slight spirometric anomalies. Thus, they were referred to the Navy Hospital of La Spezia for standardized tests: skin-prick test, nasal cytology, spirometry, and methacholine bronchial challenge. A reduced FEF 25-75 was arbitrarily defined as <80% of predicted. All 58 subjects had a normal FEV 1 , FVC, and FEV 1 /FVC ratio. Twenty subjects had a reduced FEF 25-75 , consistent with the definition of SAD. A mean value of FEF 25-75 of 70.3 (SD, 8.5) was measured in patients with a reduced FEF, and it was 108.0 (SD, 14.3) in patients with preserved FEF 25-75 . All the candidate allergic predictors appeared to be strongly associated with a reduced FEF 25-75 . The proportion of subjects with reduced FEF 25-75 appeared to increase with increasing severity of the allergic predictors, and, correspondingly, the mean value of FEF 25-75 appeared to decrease. This study provides evidence that there is a relationship between SAD and allergic parameters such as nasal symptoms and eosinophils.

Stanley J. Szefler - One of the best experts on this subject based on the ideXlab platform.

  • Forced Expiratory Flow (FEF_25–75%) as a Clinical Endpoint in Children and Adolescents with Symptomatic Asthma Receiving Tiotropium: A Post Hoc Analysis
    Pulmonary Therapy, 2020
    Co-Authors: Stanley J. Szefler, Stanley Goldstein, Christian Vogelberg, George W. Bensch, John Given, Branko Jugovic, Petra M. Moroni-zentgraf, Ralf Sigmund, Michael Engel, Eckard H. Hamelmann
    Abstract:

    Introduction In pediatric patients with asthma, measurements of Forced Expiratory volume in 1 s (FEV_1) may be normal or may not correlate with symptom severity. Forced Expiratory Flow at 25–75% of the vital capacity (FEF_25–75%) is a potentially more sensitive parameter for assessing peripheral airway function. This post hoc analysis compared FEF_25–75% with FEV_1 as an endpoint to assess bronchodilator responsiveness in children with asthma. Methods Change from baseline in trough FEF_25–75% and trough FEV_1 following treatment with either tiotropium (5 µg or 2.5 µg) or placebo Respimat^® was analyzed in four phase III trials in children (aged 6–11 years) and adolescents (aged 12–17 years) with symptomatic moderate (VivaTinA-asthma^® and PensieTinA-asthma^®) and mild (CanoTinA-asthma^® and RubaTinA-asthma^®) asthma. Data from all treatment arms were pooled and correlations between FEF_25–75% and FEV_1 were calculated and analyzed. Results A total of 1590 patients were included in the analysis. Tiotropium Respimat^® consistently improved FEF_25–75% and FEV_1 versus placebo, although in adolescents with severe asthma, the observed improvements were not statistically significant. Improvements in FEF_25–75% response with tiotropium versus placebo were largely more pronounced than improvements in FEV_1. Statistical assessment of the correlation of FEV_1 and FEF_25–75% showed moderate-to-high correlations (Pearson’s correlation coefficients 0.73–0.80). Conclusions In pediatric patients, FEF_25–75% may be a more sensitive measure to detect treatment response, certainly to tiotropium, than FEV_1 and should be evaluated as an additional lung function measurement.

  • Forced Expiratory Flow fef25 75 as a clinical endpoint in children and adolescents with symptomatic asthma receiving tiotropium a post hoc analysis
    Pulmonary therapy, 2020
    Co-Authors: Stanley J. Szefler, Stanley Goldstein, Christian Vogelberg, George W. Bensch, John Given, Branko Jugovic, Ralf Sigmund, Michael Engel, P Moronizentgraf, Eckard H. Hamelmann
    Abstract:

    INTRODUCTION: In pediatric patients with asthma, measurements of Forced Expiratory volume in 1 s (FEV1) may be normal or may not correlate with symptom severity. Forced Expiratory Flow at 25-75% of the vital capacity (FEF25-75%) is a potentially more sensitive parameter for assessing peripheral airway function. This post hoc analysis compared FEF25-75% with FEV1 as an endpoint to assess bronchodilator responsiveness in children with asthma. METHODS: Change from baseline in trough FEF25-75% and trough FEV1 following treatment with either tiotropium (5 µg or 2.5 µg) or placebo Respimat® was analyzed in four phase III trials in children (aged 6-11 years) and adolescents (aged 12-17 years) with symptomatic moderate (VivaTinA-asthma® and PensieTinA-asthma®) and mild (CanoTinA-asthma® and RubaTinA-asthma®) asthma. Data from all treatment arms were pooled and correlations between FEF25-75% and FEV1 were calculated and analyzed. RESULTS: A total of 1590 patients were included in the analysis. Tiotropium Respimat® consistently improved FEF25-75% and FEV1 versus placebo, although in adolescents with severe asthma, the observed improvements were not statistically significant. Improvements in FEF25-75% response with tiotropium versus placebo were largely more pronounced than improvements in FEV1. Statistical assessment of the correlation of FEV1 and FEF25-75% showed moderate-to-high correlations (Pearson's correlation coefficients 0.73-0.80). CONCLUSIONS: In pediatric patients, FEF25-75% may be a more sensitive measure to detect treatment response, certainly to tiotropium, than FEV1 and should be evaluated as an additional lung function measurement.

  • Forced Expiratory Flow (FEF25-75%) as a Clinical Endpoint in Children and Adolescents with Symptomatic Asthma Receiving Tiotropium: A Post Hoc Analysis.
    2020
    Co-Authors: Stanley J. Szefler, Stanley Goldstein, Christian Vogelberg, George W. Bensch, John Given, Branko Jugovic, Petra M. Moroni-zentgraf, Ralf Sigmund, Michael Engel, Eckard H. Hamelmann
    Abstract:

    INTRODUCTION: In pediatric patients with asthma, measurements of Forced Expiratory volume in 1 s (FEV1) may be normal or may not correlate with symptom severity. Forced Expiratory Flow at 25-75% of the vital capacity (FEF25-75%) is a potentially more sensitive parameter for assessing peripheral airway function. This post hoc analysis compared FEF25-75% with FEV1 as an endpoint to assess bronchodilator responsiveness in children with asthma. METHODS: Change from baseline in trough FEF25-75% and trough FEV1 following treatment with either tiotropium (5 µg or 2.5 µg) or placebo Respimat® was analyzed in four phase III trials in children (aged 6-11 years) and adolescents (aged 12-17 years) with symptomatic moderate (VivaTinA-asthma® and PensieTinA-asthma®) and mild (CanoTinA-asthma® and RubaTinA-asthma®) asthma. Data from all treatment arms were pooled and correlations between FEF25-75% and FEV1 were calculated and analyzed. RESULTS: A total of 1590 patients were included in the analysis. Tiotropium Respimat® consistently improved FEF25-75% and FEV1 versus placebo, although in adolescents with severe asthma, the observed improvements were not statistically significant. Improvements in FEF25-75% response with tiotropium versus placebo were largely more pronounced than improvements in FEV1. Statistical assessment of the correlation of FEV1 and FEF25-75% showed moderate-to-high correlations (Pearson's correlation coefficients 0.73-0.80). CONCLUSIONS: In pediatric patients, FEF25-75% may be a more sensitive measure to detect treatment response, certainly to tiotropium, than FEV1 and should be evaluated as an additional lung function measurement.

  • Forced Expiratory Flow between 25 and 75 of vital capacity and fev1 Forced vital capacity ratio in relation to clinical and physiological parameters in asthmatic children with normal fev1 values
    The Journal of Allergy and Clinical Immunology, 2010
    Co-Authors: Michael R Simon, Stanley J. Szefler, Vernon M Chinchilli, Brenda R Phillips, Christine A Sorkness, Robert F Lemanske, Lynn M Taussig, Leonard B Bacharier, Wayne J Morgan
    Abstract:

    Background The assumption that the assessment of Forced Expiratory Flow between 25% and 75% of vital capacity (FEF 25-75 ) does not provide additional information in asthmatic children with normal FEV 1 percent predicted has not been adequately tested. Objective We sought to determine whether the measurement of FEF 25-75 percent predicted offers advantages over FEV 1 percent predicted and FEV 1 /Forced vital capacity (FVC) percent predicted for the evaluation of childhood asthma. Methods This is a secondary analysis of data from the Pediatric Asthma Controller Trial and the Characterizing the Response to a Leukotriene Receptor Antagonist and Inhaled Corticosteroid trials. Pearson correlation coefficients, Pearson partial correlation coefficients, canonical correlations, and receiver operating characteristic (ROC) curves were constructed. Results Among 437 children with normal FEV 1 percent predicted, FEF 25-75 percent predicted, and FEV 1 /FVC percent predicted were (1) positively correlated with log 2 methacholine PC 20 , (2) positively correlated with morning and evening peak Expiratory Flow percent predicted, and (3) negatively correlated with log 10 fraction of exhaled nitric oxide and bronchodilator responsiveness. Pearson partial correlations and canonical correlations indicated that FEF 25-75 percent predicted was better correlated with bronchodilator responsiveness and log 2 methacholine PC 20 than were FEV 1 percent predicted or FEV 1 /FVC percent predicted. In the ROC curve analysis, FEF 25-75 at 65% of predicted value had a 90% sensitivity and a 67% specificity for detecting a 20% increase in FEV 1 after albuterol inhalation. Conclusion FEF 25-75 percent predicted was well correlated with bronchodilator responsiveness in asthmatic children with normal FEV 1 . FEF 25-75 percent predicted should be evaluated in clinical studies of asthma in children and might be of use in predicting the presence of clinically relevant reversible airFlow obstruction.

  • Forced Expiratory Flow between 25% and 75% of vital capacity and FEV1/Forced vital capacity ratio in relation to clinical and physiological parameters in asthmatic children with normal FEV1 values
    The Journal of Allergy and Clinical Immunology, 2010
    Co-Authors: Michael R Simon, Stanley J. Szefler, Vernon M Chinchilli, Brenda R Phillips, Christine A Sorkness, Robert F Lemanske, Lynn M Taussig, Leonard B Bacharier, Wayne J Morgan
    Abstract:

    Background The assumption that the assessment of Forced Expiratory Flow between 25% and 75% of vital capacity (FEF 25-75 ) does not provide additional information in asthmatic children with normal FEV 1 percent predicted has not been adequately tested. Objective We sought to determine whether the measurement of FEF 25-75 percent predicted offers advantages over FEV 1 percent predicted and FEV 1 /Forced vital capacity (FVC) percent predicted for the evaluation of childhood asthma. Methods This is a secondary analysis of data from the Pediatric Asthma Controller Trial and the Characterizing the Response to a Leukotriene Receptor Antagonist and Inhaled Corticosteroid trials. Pearson correlation coefficients, Pearson partial correlation coefficients, canonical correlations, and receiver operating characteristic (ROC) curves were constructed. Results Among 437 children with normal FEV 1 percent predicted, FEF 25-75 percent predicted, and FEV 1 /FVC percent predicted were (1) positively correlated with log 2 methacholine PC 20 , (2) positively correlated with morning and evening peak Expiratory Flow percent predicted, and (3) negatively correlated with log 10 fraction of exhaled nitric oxide and bronchodilator responsiveness. Pearson partial correlations and canonical correlations indicated that FEF 25-75 percent predicted was better correlated with bronchodilator responsiveness and log 2 methacholine PC 20 than were FEV 1 percent predicted or FEV 1 /FVC percent predicted. In the ROC curve analysis, FEF 25-75 at 65% of predicted value had a 90% sensitivity and a 67% specificity for detecting a 20% increase in FEV 1 after albuterol inhalation. Conclusion FEF 25-75 percent predicted was well correlated with bronchodilator responsiveness in asthmatic children with normal FEV 1 . FEF 25-75 percent predicted should be evaluated in clinical studies of asthma in children and might be of use in predicting the presence of clinically relevant reversible airFlow obstruction.