Longitudinal changes in %PEF (A), %VC (B), and FEV1.0/FVC (C) as a function of disease duration were analyzed. The solid lines indicate representative disease progression over disease duration calculated using a marginal model under an unstructured covariance matrix. The broken curvilinear line demonstrates the 95% confidence interval of these models. We calculated the estimated values at clinical onset (intercepts) and the change values per year (D). In an analysis using the marginal model, a generalized estimating equation (shown by the solid lines) identified that %PEF (A) and %FVC (B) demonstrated a slowly but with steady progression. PEF, peak expiratory flow; FVC, forced vital capacity; FEV1.0, forced expiratory volume in 1 s.