Bronchodilator Responsiveness in Tobacco-Exposed People With or Without COPD

Published by Elsevier Inc..

BACKGROUND: Bronchodilator responsiveness (BDR) in obstructive lung disease varies over time and may be associated with distinct clinical features.

RESEARCH QUESTION: Is consistent BDR over time (always present) differentially associated with obstructive lung disease features relative to inconsistent (sometimes present) or never (never present) BDR in tobacco-exposed people with or without COPD?.

STUDY DESIGN AND METHODS: We retrospectively analyzed data from 2,269 tobacco-exposed participants in the Subpopulations and Intermediate Outcome Measures in COPD Study with or without COPD. We used various BDR definitions: change of ≥ 200 mL and ≥ 12% in FEV1 (FEV1-BDR), change in FVC (FVC-BDR), and change in in FEV1, FVC or both (ATS-BDR). Using generalized linear models adjusted for demographics, smoking history, FEV1 % predicted after bronchodilator administration, and number of visits that the participant completed, we assessed the association of BDR group: (1) consistent BDR, (2) inconsistent BDR, and (3) never BDR with asthma, CT scan features, blood eosinophil levels, and FEV1 decline in participants without COPD (Global Initiative for Chronic Obstructive Lung Disease [GOLD] stage 0) and the entire cohort (participants with or without COPD).

RESULTS: Both consistent and inconsistent ATS-BDR were associated with asthma history and greater small airways disease (%parametric response mapping functional small airways disease) relative to never ATS-BDR in participants with GOLD stage 0 disease and the entire cohort. We observed similar findings using FEV1-BDR and FVC-BDR definitions. Eosinophils did not vary consistently among BDR groups. Consistent BDR was associated with FEV1 decline over time relative to never BDR in the entire cohort. In participants with GOLD stage 0 disease, both the inconsistent ATS-BDR group (OR, 3.20; 95% CI, 2.21-4.66; P < .001) and consistent ATS-BDR group (OR, 9.48; 95% CI, 3.77-29.12; P < .001) were associated with progression to COPD relative to the never ATS-BDR group.

INTERPRETATION: Demonstration of BDR, even once, describes an obstructive lung disease phenotype with a history of asthma and greater small airways disease. Consistent demonstration of BDR indicated a high risk of lung function decline over time in the entire cohort and was associated with higher risk of progression to COPD in patients with GOLD stage 0 disease.

Errataetall:

CommentIn: Chest. 2023 Apr;163(4):736-737. - PMID 37031975

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:163

Enthalten in:

Chest - 163(2023), 3 vom: 15. März, Seite 502-514

Sprache:

Englisch

Beteiligte Personen:

Fortis, Spyridon [VerfasserIn]
Quibrera, Pedro M [VerfasserIn]
Comellas, Alejandro P [VerfasserIn]
Bhatt, Surya P [VerfasserIn]
Tashkin, Donald P [VerfasserIn]
Hoffman, Eric A [VerfasserIn]
Criner, Gerard J [VerfasserIn]
Han, MeiLan K [VerfasserIn]
Barr, R Graham [VerfasserIn]
Arjomandi, Mehrdad [VerfasserIn]
Dransfield, Mark B [VerfasserIn]
Peters, Stephen P [VerfasserIn]
Dolezal, Brett A [VerfasserIn]
Kim, Victor [VerfasserIn]
Putcha, Nirupama [VerfasserIn]
Rennard, Stephen I [VerfasserIn]
Paine, Robert [VerfasserIn]
Kanner, Richard E [VerfasserIn]
Curtis, Jeffrey L [VerfasserIn]
Bowler, Russell P [VerfasserIn]
Martinez, Fernando J [VerfasserIn]
Hansel, Nadia N [VerfasserIn]
Krishnan, Jerry A [VerfasserIn]
Woodruff, Prescott G [VerfasserIn]
Barjaktarevic, Igor Z [VerfasserIn]
Couper, David [VerfasserIn]
Anderson, Wayne H [VerfasserIn]
Cooper, Christopher B [VerfasserIn]
Subpopulations and Intermediate Outcome Measures in COPD Study Investigators [VerfasserIn]
Alexis, Neil E [Sonstige Person]
Anderson, Wayne H [Sonstige Person]
Arjomandi, Mehrdad [Sonstige Person]
Barjaktarevic, Igor [Sonstige Person]
Barr, R Graham [Sonstige Person]
Basta, Patricia [Sonstige Person]
Bateman, Lori A [Sonstige Person]
Bhatt, Surya P [Sonstige Person]
Bleecker, Eugene R [Sonstige Person]
Boucher, Richard C [Sonstige Person]
Bowler, Russell P [Sonstige Person]
Christenson, Stephanie A [Sonstige Person]
Comellas, Alejandro P [Sonstige Person]
Cooper, Christopher B [Sonstige Person]
Couper, David J [Sonstige Person]
Criner, Gerard J [Sonstige Person]
Crystal, Ronald G [Sonstige Person]
Curtis, Jeffrey L [Sonstige Person]
Doerschuk, Claire M [Sonstige Person]
Dransfield, Mark T [Sonstige Person]
Drummond, Brad [Sonstige Person]
Freeman, Christine M [Sonstige Person]
Galban, Craig [Sonstige Person]
Han, MeiLan K [Sonstige Person]
Hansel, Nadia N [Sonstige Person]
Hastie, Annette T [Sonstige Person]
Hoffman, Eric A [Sonstige Person]
Huang, Yvonne [Sonstige Person]
Kaner, Robert J [Sonstige Person]
Kanner, Richard E [Sonstige Person]
Kleerup, Eric C [Sonstige Person]
Krishnan, Jerry A [Sonstige Person]
LaVange, Lisa M [Sonstige Person]
Lazarus, Stephen C [Sonstige Person]
Martinez, Fernando J [Sonstige Person]
Meyers, Deborah A [Sonstige Person]
Moore, Wendy C [Sonstige Person]
Newell, John D [Sonstige Person]
Paine, Robert [Sonstige Person]
Paulin, Laura [Sonstige Person]
Peters, Stephen P [Sonstige Person]
Pirozzi, Cheryl [Sonstige Person]
Putcha, Nirupama [Sonstige Person]
Oelsner, Elizabeth C [Sonstige Person]
O'Neal, Wanda K [Sonstige Person]
Ortega, Victor E [Sonstige Person]
Raman, Sanjeev [Sonstige Person]
Rennard, Stephen I [Sonstige Person]
Tashkin, Donald P [Sonstige Person]
Wells, J Michael [Sonstige Person]
Wise, Robert A [Sonstige Person]
Woodruff, Prescott G [Sonstige Person]

Links:

Volltext

Themen:

Bronchodilator
Bronchodilator Agents
Bronchodilator response
Bronchodilator responsiveness
Bronchodilator reversibility
COPD
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Anmerkungen:

Date Completed 13.03.2023

Date Revised 23.04.2024

published: Print-Electronic

CommentIn: Chest. 2023 Apr;163(4):736-737. - PMID 37031975

Citation Status MEDLINE

doi:

10.1016/j.chest.2022.11.009

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM349091536