Turner, Steve, Filipow, Nicole, Petsky, Helen, Chang, Anne B., Frischer, Thomas, Szefler, Stanley J., Vermeulen, Francoise, and Stanojevic, Sanja (2026) What Magnitude of Change in FEV1 is Associated With Increased Odds for Asthma Exacerbation and Loss of Control? Pediatric Pulmonology, 61. e71467.

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Abstract

Background Spirometry (FEV1) is often measured as part of ongoing asthma management, but little is understood about what merits a clinically meaningful change in FEV1.

Metholology Data were collated from five clinical trials where FEV1 was measured at 3-month intervals. Change in FEV1 over 3-months was expressed as: FEV1 change score (Zc), absolute change in %FEV1 (∆FEV1%) and absolute change in FEV1 z score (∆FEV1z). The association between change in FEV1 over 3 months and asthma outcomes in the following 3 months was estimated using logistic regression.

Results Data from 1264 children were analysed. Declines in in Zc between 1.1 and 2.9, in ∆FEV1% between 12% and 23% and in ∆FEV1z between 0.9 and 2.0, were associated with increased odds ratio (OR) for later asthma exacerbation of between 1.3 and 2.3. Unexpectedly, rises in Zc of 1.7-1.9 and in ∆FEV1% of 14 and 18 were also associated with increased OR for a future exacerbation of between 1.3 and 1.6. Among children with controlled asthma symptoms, declines in Zc of 1.7, in ∆FEV1% of 11 and 14 and in ∆FEV1z of 0.8-1.1 were associated with increases in OR for future loss of control of between 1.5 and 1.7. Rises in all three indices of change in FEV1 were associated with reduced OR between 0.4 and 0.7 for future loss of control. A lower initial FEV1 z score was associated with higher variability in longitudinal FEV1 z-score measurements.

Conclusions FEV1 variability, and not simply a fall in FEV1, identifies children at increased risk for future asthma exacerbations. The clinical relevance of a single FEV1 may be uncertain.

Item ID:	90876
Item Type:	Article (Research - C1)
ISSN:	1099-0496
Copyright Information:	© 2026 Wiley Periodicals LLC
Date Deposited:	16 Jun 2026 01:48
FoR Codes:	32 BIOMEDICAL AND CLINICAL SCIENCES > 3201 Cardiovascular medicine and haematology > 320103 Respiratory diseases @ 100%
SEO Codes:	20 HEALTH > 2001 Clinical health > 200104 Prevention of human diseases and conditions @ 100%
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