Worldwide patterns of bronchodilator responsiveness: Results from the Burden of Obstructive Lung Disease study

Wan C. Tan, William M. Vollmer, Bernd Lamprecht, David M. Mannino, Anamika Jithoo, Ewa Nizankowska-Mogilnicka, Filip Mejza, Thorarinn Gislason, Peter G J Burney, A (Sonia) Buist

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Rationale: Criteria for a clinically significant bronchodilator response (BDR) are mainly based on studies in patients with obstructive lung diseases. Little is known about the BDR in healthy general populations, and even less about the worldwide patterns. Methods: 10 360 adults aged 40 years and older from 14 countries in North America, Europe, Africa and Asia participated in the Burden of Obstructive Lung Disease study. Spirometry was used before and after an inhaled bronchodilator to determine the distribution of the BDR in population-based samples of healthy non-smokers and individuals with airflow obstruction. Results: In 3922 healthy never smokers, the weighted pooled estimate of the 95th percentiles (95% CI) for bronchodilator response were 284 ml (263 to 305) absolute change in forced expiratory volume in 1 s from baseline (ΔFEV 1); 12.0% (11.2% to 12.8%) change relative to initial value (%ΔFEV 1i); and 10.0% (9.5% to 10.5%) change relative to predicted value (%ΔFEV 1p). The corresponding mean changes in forced vital capacity (FVC) were 322 ml (271 to 373) absolute change from baseline (ΔFVC); 10.5% (8.9% to 12.0%) change relative to initial value (ΔFVC i); and 9.2% (7.9% to 10.5%) change relative to predicted value (ΔFVC p). The proportion who exceeded the above threshold values in the subgroup with spirometrically defined Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 2 and higher (FEV 1/FVC 1% predicted 1-based thresholds and 22.6%, 28.6% and 22.1% respectively for the FVC-based thresholds. Conclusions: The results provide reference values for bronchodilator responses worldwide that confirm guideline estimates for a clinically significant level of BDR in bronchodilator testing.

Original languageEnglish (US)
Pages (from-to)718-726
Number of pages9
JournalThorax
Volume67
Issue number8
DOIs
StatePublished - Aug 2012

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Obstructive Lung Diseases
Bronchodilator Agents
Vital Capacity
Northern Asia
Spirometry
Forced Expiratory Volume
North America
Chronic Obstructive Pulmonary Disease
Population
Reference Values
Guidelines

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Tan, W. C., Vollmer, W. M., Lamprecht, B., Mannino, D. M., Jithoo, A., Nizankowska-Mogilnicka, E., ... Buist, A. S. (2012). Worldwide patterns of bronchodilator responsiveness: Results from the Burden of Obstructive Lung Disease study. Thorax, 67(8), 718-726. https://doi.org/10.1136/thoraxjnl-2011-201445

Worldwide patterns of bronchodilator responsiveness : Results from the Burden of Obstructive Lung Disease study. / Tan, Wan C.; Vollmer, William M.; Lamprecht, Bernd; Mannino, David M.; Jithoo, Anamika; Nizankowska-Mogilnicka, Ewa; Mejza, Filip; Gislason, Thorarinn; Burney, Peter G J; Buist, A (Sonia).

In: Thorax, Vol. 67, No. 8, 08.2012, p. 718-726.

Research output: Contribution to journalArticle

Tan, WC, Vollmer, WM, Lamprecht, B, Mannino, DM, Jithoo, A, Nizankowska-Mogilnicka, E, Mejza, F, Gislason, T, Burney, PGJ & Buist, AS 2012, 'Worldwide patterns of bronchodilator responsiveness: Results from the Burden of Obstructive Lung Disease study', Thorax, vol. 67, no. 8, pp. 718-726. https://doi.org/10.1136/thoraxjnl-2011-201445
Tan WC, Vollmer WM, Lamprecht B, Mannino DM, Jithoo A, Nizankowska-Mogilnicka E et al. Worldwide patterns of bronchodilator responsiveness: Results from the Burden of Obstructive Lung Disease study. Thorax. 2012 Aug;67(8):718-726. https://doi.org/10.1136/thoraxjnl-2011-201445
Tan, Wan C. ; Vollmer, William M. ; Lamprecht, Bernd ; Mannino, David M. ; Jithoo, Anamika ; Nizankowska-Mogilnicka, Ewa ; Mejza, Filip ; Gislason, Thorarinn ; Burney, Peter G J ; Buist, A (Sonia). / Worldwide patterns of bronchodilator responsiveness : Results from the Burden of Obstructive Lung Disease study. In: Thorax. 2012 ; Vol. 67, No. 8. pp. 718-726.
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abstract = "Rationale: Criteria for a clinically significant bronchodilator response (BDR) are mainly based on studies in patients with obstructive lung diseases. Little is known about the BDR in healthy general populations, and even less about the worldwide patterns. Methods: 10 360 adults aged 40 years and older from 14 countries in North America, Europe, Africa and Asia participated in the Burden of Obstructive Lung Disease study. Spirometry was used before and after an inhaled bronchodilator to determine the distribution of the BDR in population-based samples of healthy non-smokers and individuals with airflow obstruction. Results: In 3922 healthy never smokers, the weighted pooled estimate of the 95th percentiles (95{\%} CI) for bronchodilator response were 284 ml (263 to 305) absolute change in forced expiratory volume in 1 s from baseline (ΔFEV 1); 12.0{\%} (11.2{\%} to 12.8{\%}) change relative to initial value ({\%}ΔFEV 1i); and 10.0{\%} (9.5{\%} to 10.5{\%}) change relative to predicted value ({\%}ΔFEV 1p). The corresponding mean changes in forced vital capacity (FVC) were 322 ml (271 to 373) absolute change from baseline (ΔFVC); 10.5{\%} (8.9{\%} to 12.0{\%}) change relative to initial value (ΔFVC i); and 9.2{\%} (7.9{\%} to 10.5{\%}) change relative to predicted value (ΔFVC p). The proportion who exceeded the above threshold values in the subgroup with spirometrically defined Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 2 and higher (FEV 1/FVC 1{\%} predicted 1-based thresholds and 22.6{\%}, 28.6{\%} and 22.1{\%} respectively for the FVC-based thresholds. Conclusions: The results provide reference values for bronchodilator responses worldwide that confirm guideline estimates for a clinically significant level of BDR in bronchodilator testing.",
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AU - Jithoo, Anamika

AU - Nizankowska-Mogilnicka, Ewa

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