Bronchodilator reversibility in asthma and COPD

Findings from three large population studies

Christer Janson, Andrei Malinovschi, Andre F.S. Amaral, Simone Accordini, Jean Bousquet, A (Sonia) Buist, Giorgio Walter Canonica, Barbro Dahlén, Judith Garcia-Aymerich, Louisa Gnatiuc, Marek L. Kowalski, Jaymini Patel, Wan Tan, Kjell Torén, Torsten Zuberbier, Peter Burney, Deborah Jarvis

Research output: Contribution to journalArticle

Abstract

Bronchodilator response (BDR) testing is used as a diagnostic method in obstructive airway diseases. The aim of this investigation was to compare different methods for measuring BDR in participants with asthma and chronic obstructive pulmonary disease (COPD) and to study to the extent to which BDR was related to symptom burden and phenotypic characteristics. Forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were measured before and 15 min after 200 μg of salbutamol in 35 628 subjects aged ≥16 years from three large international population studies. The subjects were categorised in three groups: current asthma (n=2833), COPD (n=1146) and no airway disease (n=31 649). Three definitions for flow-related reversibility (increase in FEV1) and three for volume-related reversibility (increase in FVC) were used. The prevalence of bronchodilator reversibility expressed as increase FEV1 ≥12% and 200 mL was 17.3% and 18.4% in participants with asthma and COPD, respectively, while the corresponding prevalence was 5.1% in those with no airway disease. In asthma, bronchodilator reversibility was associated with wheeze (OR 1.36, 95% CI 1.04-1.79), atopy (OR 1.36, 95% CI 1.04-1.79) and higher exhaled nitric oxide fraction, while in COPD neither flow- nor volume-related bronchodilator reversibility was associated with symptom burden, exacerbations or health status after adjusting for pre-bronchodilator FEV1. Bronchodilator reversibility was at least as common in participants with COPD as those with asthma. This indicates that measures of reversibility are of limited value for distinguishing asthma from COPD in population studies. However, in asthma, bronchodilator reversibility may be a phenotypic marker.

Original languageEnglish (US)
Article number1900561
JournalEuropean Respiratory Journal
Volume54
Issue number3
DOIs
StatePublished - Sep 1 2019

Fingerprint

Bronchodilator Agents
Chronic Obstructive Pulmonary Disease
Asthma
Forced Expiratory Volume
Population
Vital Capacity
Albuterol
Health Status
Nitric Oxide

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Janson, C., Malinovschi, A., Amaral, A. F. S., Accordini, S., Bousquet, J., Buist, A. S., ... Jarvis, D. (2019). Bronchodilator reversibility in asthma and COPD: Findings from three large population studies. European Respiratory Journal, 54(3), [1900561]. https://doi.org/10.1183/13993003.00561-2019

Bronchodilator reversibility in asthma and COPD : Findings from three large population studies. / Janson, Christer; Malinovschi, Andrei; Amaral, Andre F.S.; Accordini, Simone; Bousquet, Jean; Buist, A (Sonia); Canonica, Giorgio Walter; Dahlén, Barbro; Garcia-Aymerich, Judith; Gnatiuc, Louisa; Kowalski, Marek L.; Patel, Jaymini; Tan, Wan; Torén, Kjell; Zuberbier, Torsten; Burney, Peter; Jarvis, Deborah.

In: European Respiratory Journal, Vol. 54, No. 3, 1900561, 01.09.2019.

Research output: Contribution to journalArticle

Janson, C, Malinovschi, A, Amaral, AFS, Accordini, S, Bousquet, J, Buist, AS, Canonica, GW, Dahlén, B, Garcia-Aymerich, J, Gnatiuc, L, Kowalski, ML, Patel, J, Tan, W, Torén, K, Zuberbier, T, Burney, P & Jarvis, D 2019, 'Bronchodilator reversibility in asthma and COPD: Findings from three large population studies', European Respiratory Journal, vol. 54, no. 3, 1900561. https://doi.org/10.1183/13993003.00561-2019
Janson, Christer ; Malinovschi, Andrei ; Amaral, Andre F.S. ; Accordini, Simone ; Bousquet, Jean ; Buist, A (Sonia) ; Canonica, Giorgio Walter ; Dahlén, Barbro ; Garcia-Aymerich, Judith ; Gnatiuc, Louisa ; Kowalski, Marek L. ; Patel, Jaymini ; Tan, Wan ; Torén, Kjell ; Zuberbier, Torsten ; Burney, Peter ; Jarvis, Deborah. / Bronchodilator reversibility in asthma and COPD : Findings from three large population studies. In: European Respiratory Journal. 2019 ; Vol. 54, No. 3.
@article{d73394577a9448b9a816a1a6b79be220,
title = "Bronchodilator reversibility in asthma and COPD: Findings from three large population studies",
abstract = "Bronchodilator response (BDR) testing is used as a diagnostic method in obstructive airway diseases. The aim of this investigation was to compare different methods for measuring BDR in participants with asthma and chronic obstructive pulmonary disease (COPD) and to study to the extent to which BDR was related to symptom burden and phenotypic characteristics. Forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were measured before and 15 min after 200 μg of salbutamol in 35 628 subjects aged ≥16 years from three large international population studies. The subjects were categorised in three groups: current asthma (n=2833), COPD (n=1146) and no airway disease (n=31 649). Three definitions for flow-related reversibility (increase in FEV1) and three for volume-related reversibility (increase in FVC) were used. The prevalence of bronchodilator reversibility expressed as increase FEV1 ≥12{\%} and 200 mL was 17.3{\%} and 18.4{\%} in participants with asthma and COPD, respectively, while the corresponding prevalence was 5.1{\%} in those with no airway disease. In asthma, bronchodilator reversibility was associated with wheeze (OR 1.36, 95{\%} CI 1.04-1.79), atopy (OR 1.36, 95{\%} CI 1.04-1.79) and higher exhaled nitric oxide fraction, while in COPD neither flow- nor volume-related bronchodilator reversibility was associated with symptom burden, exacerbations or health status after adjusting for pre-bronchodilator FEV1. Bronchodilator reversibility was at least as common in participants with COPD as those with asthma. This indicates that measures of reversibility are of limited value for distinguishing asthma from COPD in population studies. However, in asthma, bronchodilator reversibility may be a phenotypic marker.",
author = "Christer Janson and Andrei Malinovschi and Amaral, {Andre F.S.} and Simone Accordini and Jean Bousquet and Buist, {A (Sonia)} and Canonica, {Giorgio Walter} and Barbro Dahl{\'e}n and Judith Garcia-Aymerich and Louisa Gnatiuc and Kowalski, {Marek L.} and Jaymini Patel and Wan Tan and Kjell Tor{\'e}n and Torsten Zuberbier and Peter Burney and Deborah Jarvis",
year = "2019",
month = "9",
day = "1",
doi = "10.1183/13993003.00561-2019",
language = "English (US)",
volume = "54",
journal = "European Respiratory Journal, Supplement",
issn = "0903-1936",
publisher = "European Respiratory Society",
number = "3",

}

TY - JOUR

T1 - Bronchodilator reversibility in asthma and COPD

T2 - Findings from three large population studies

AU - Janson, Christer

AU - Malinovschi, Andrei

AU - Amaral, Andre F.S.

AU - Accordini, Simone

AU - Bousquet, Jean

AU - Buist, A (Sonia)

AU - Canonica, Giorgio Walter

AU - Dahlén, Barbro

AU - Garcia-Aymerich, Judith

AU - Gnatiuc, Louisa

AU - Kowalski, Marek L.

AU - Patel, Jaymini

AU - Tan, Wan

AU - Torén, Kjell

AU - Zuberbier, Torsten

AU - Burney, Peter

AU - Jarvis, Deborah

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Bronchodilator response (BDR) testing is used as a diagnostic method in obstructive airway diseases. The aim of this investigation was to compare different methods for measuring BDR in participants with asthma and chronic obstructive pulmonary disease (COPD) and to study to the extent to which BDR was related to symptom burden and phenotypic characteristics. Forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were measured before and 15 min after 200 μg of salbutamol in 35 628 subjects aged ≥16 years from three large international population studies. The subjects were categorised in three groups: current asthma (n=2833), COPD (n=1146) and no airway disease (n=31 649). Three definitions for flow-related reversibility (increase in FEV1) and three for volume-related reversibility (increase in FVC) were used. The prevalence of bronchodilator reversibility expressed as increase FEV1 ≥12% and 200 mL was 17.3% and 18.4% in participants with asthma and COPD, respectively, while the corresponding prevalence was 5.1% in those with no airway disease. In asthma, bronchodilator reversibility was associated with wheeze (OR 1.36, 95% CI 1.04-1.79), atopy (OR 1.36, 95% CI 1.04-1.79) and higher exhaled nitric oxide fraction, while in COPD neither flow- nor volume-related bronchodilator reversibility was associated with symptom burden, exacerbations or health status after adjusting for pre-bronchodilator FEV1. Bronchodilator reversibility was at least as common in participants with COPD as those with asthma. This indicates that measures of reversibility are of limited value for distinguishing asthma from COPD in population studies. However, in asthma, bronchodilator reversibility may be a phenotypic marker.

AB - Bronchodilator response (BDR) testing is used as a diagnostic method in obstructive airway diseases. The aim of this investigation was to compare different methods for measuring BDR in participants with asthma and chronic obstructive pulmonary disease (COPD) and to study to the extent to which BDR was related to symptom burden and phenotypic characteristics. Forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were measured before and 15 min after 200 μg of salbutamol in 35 628 subjects aged ≥16 years from three large international population studies. The subjects were categorised in three groups: current asthma (n=2833), COPD (n=1146) and no airway disease (n=31 649). Three definitions for flow-related reversibility (increase in FEV1) and three for volume-related reversibility (increase in FVC) were used. The prevalence of bronchodilator reversibility expressed as increase FEV1 ≥12% and 200 mL was 17.3% and 18.4% in participants with asthma and COPD, respectively, while the corresponding prevalence was 5.1% in those with no airway disease. In asthma, bronchodilator reversibility was associated with wheeze (OR 1.36, 95% CI 1.04-1.79), atopy (OR 1.36, 95% CI 1.04-1.79) and higher exhaled nitric oxide fraction, while in COPD neither flow- nor volume-related bronchodilator reversibility was associated with symptom burden, exacerbations or health status after adjusting for pre-bronchodilator FEV1. Bronchodilator reversibility was at least as common in participants with COPD as those with asthma. This indicates that measures of reversibility are of limited value for distinguishing asthma from COPD in population studies. However, in asthma, bronchodilator reversibility may be a phenotypic marker.

UR - http://www.scopus.com/inward/record.url?scp=85071785320&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85071785320&partnerID=8YFLogxK

U2 - 10.1183/13993003.00561-2019

DO - 10.1183/13993003.00561-2019

M3 - Article

VL - 54

JO - European Respiratory Journal, Supplement

JF - European Respiratory Journal, Supplement

SN - 0903-1936

IS - 3

M1 - 1900561

ER -