Role of FEF(25-75) in managing children with newly-diagnosed asthma in clinical practice

BACKGROUND: Reversible bronchial obstruction characterizes asthma. Spirometry is the gold standard to assess airflow, and FEV(1) is the most reliable parameter in this regard. However, many children with asthma have FEV(1) within the normal range despite uncontrolled asthma and worsening. Therefore, FEF(25-75) has been proposed as a valuable marker of early airflow impairment. This study aimed at investigating FEF(25-75) in a cohort of children with newly diagnosed asthma. METHODS: 381 children (122 females, mean age 11.6 years) were consecutively visited and had a new asthma diagnosis. In addition, Spirometry, type-2 phenotyping, asthma control assessment, and ACT were performed. RESULTS: 72 (18.9%) asthmatic children had impaired FEF(25-75), such as <65% of predicted. Low FEF(25-75) was associated with lower FVC and FEV(1)/FVC values (OR 1.11 and 1.32, respectively). Children with normal FEV(1) but impaired FEF(25-75) had more frequently uncontrolled asthma (15.8% vs. 32.4%) than children with both parameters within the normal range. CONCLUSIONS: FEF(25-75) deserves adequate and careful consideration in children with asthma, and the presence of impaired FEF(25-75) values suggests a more compelling approach. (www.actabiomedica.it)