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 language | English (US) |
|---|---|
| Article number | 1900561 |
| Journal | European Respiratory Journal |
| Volume | 54 |
| Issue number | 3 |
| DOIs | |
| State | Published - Sep 1 2019 |
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ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
Cite this
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 journal › Article
}
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
C2 - 31221806
AN - SCOPUS:85071785320
VL - 54
JO - European Respiratory Journal, Supplement
JF - European Respiratory Journal, Supplement
SN - 0903-1936
IS - 3
M1 - 1900561
ER -