Prevalence, Diagnostic Utility and Associated Characteristics of Bronchodilator Responsiveness
Rationale: The prevalence and diagnostic utility of bronchodilator responsiveness (BDR) in a real-life setting is unclear. Objective: To explore this uncertainty in patients aged ⩾12 years with physician-assigned diagnoses of asthma, asthma and chronic obstructive pulmonary disease (COPD), or COPD in NOVELTY, a prospective cohort study in primary and secondary care in 18 countries. Methods: The proportion of patients with a positive BDR test in each diagnostic category was calculated using 2005 (ΔFEV1 or ΔFVC ⩾12% and ⩾200 ml) and 2021 (ΔFEV1 or ΔFVC >10% predicted) European Respiratory Society/American Thoracic Society criteria. Measurements and Main Results: We studied 3,519 patients with a physician-assigned diagnosis of asthma, 833 with a diagnosis of asthma + COPD, and 2,436 with a diagnosis of COPD. The prevalence of BDR was 19.7% (asthma), 29.6% (asthma + COPD), and 24.7% (COPD) using 2005 criteria and 18.1%, 23.3%, and 18.0%, respectively, using 2021 criteria. Using 2021 criteria in patients diagnosed with asthma, BDR was associated with higher fractional exhaled nitric oxide; lower lung function; higher symptom burden; more frequent hospital admissions; and greater use of triple therapy, oral corticosteroids, or biologics. In patients diagnosed with COPD, BDR (2021) was associated with lower lung function and higher symptom burden. Conclusions: BDR prevalence in patients with chronic airway diseases receiving treatment ranges from 18% to 30%, being modestly lower with the 2021 than with the 2005 European Respiratory Society/American Thoracic Society criteria, and it is associated with lower lung function and greater symptom burden. These observations question the validity of BDR as a key diagnostic tool for asthma managed in clinical practice or as a standard inclusion criterion for clinical trials of asthma and instead suggest that BDR be considered a treatable trait for chronic airway disease.
| Errataetall: |
CommentIn: Am J Respir Crit Care Med. 2024 Feb 15;209(4):349-351. - PMID 38190497 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:209 |
|---|---|
| Enthalten in: |
American journal of respiratory and critical care medicine - 209(2024), 4 vom: 15. Feb., Seite 390-401 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Beasley, Richard [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Asthma |
|---|
| Anmerkungen: |
Date Completed 16.02.2024 Date Revised 22.02.2024 published: Print CommentIn: Am J Respir Crit Care Med. 2024 Feb 15;209(4):349-351. - PMID 38190497 Citation Status MEDLINE |
|---|
| doi: |
10.1164/rccm.202308-1436OC |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM365204390 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM365204390 | ||
| 003 | DE-627 | ||
| 005 | 20240222232136.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1164/rccm.202308-1436OC |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1302.xml |
| 035 | |a (DE-627)NLM365204390 | ||
| 035 | |a (NLM)38029294 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Beasley, Richard |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Prevalence, Diagnostic Utility and Associated Characteristics of Bronchodilator Responsiveness |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 16.02.2024 | ||
| 500 | |a Date Revised 22.02.2024 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Am J Respir Crit Care Med. 2024 Feb 15;209(4):349-351. - PMID 38190497 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Rationale: The prevalence and diagnostic utility of bronchodilator responsiveness (BDR) in a real-life setting is unclear. Objective: To explore this uncertainty in patients aged ⩾12 years with physician-assigned diagnoses of asthma, asthma and chronic obstructive pulmonary disease (COPD), or COPD in NOVELTY, a prospective cohort study in primary and secondary care in 18 countries. Methods: The proportion of patients with a positive BDR test in each diagnostic category was calculated using 2005 (ΔFEV1 or ΔFVC ⩾12% and ⩾200 ml) and 2021 (ΔFEV1 or ΔFVC >10% predicted) European Respiratory Society/American Thoracic Society criteria. Measurements and Main Results: We studied 3,519 patients with a physician-assigned diagnosis of asthma, 833 with a diagnosis of asthma + COPD, and 2,436 with a diagnosis of COPD. The prevalence of BDR was 19.7% (asthma), 29.6% (asthma + COPD), and 24.7% (COPD) using 2005 criteria and 18.1%, 23.3%, and 18.0%, respectively, using 2021 criteria. Using 2021 criteria in patients diagnosed with asthma, BDR was associated with higher fractional exhaled nitric oxide; lower lung function; higher symptom burden; more frequent hospital admissions; and greater use of triple therapy, oral corticosteroids, or biologics. In patients diagnosed with COPD, BDR (2021) was associated with lower lung function and higher symptom burden. Conclusions: BDR prevalence in patients with chronic airway diseases receiving treatment ranges from 18% to 30%, being modestly lower with the 2021 than with the 2005 European Respiratory Society/American Thoracic Society criteria, and it is associated with lower lung function and greater symptom burden. These observations question the validity of BDR as a key diagnostic tool for asthma managed in clinical practice or as a standard inclusion criterion for clinical trials of asthma and instead suggest that BDR be considered a treatable trait for chronic airway disease | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a BDR | |
| 650 | 4 | |a asthma | |
| 650 | 4 | |a chronic obstructive pulmonary disease | |
| 650 | 4 | |a diagnosis | |
| 650 | 7 | |a Bronchodilator Agents |2 NLM | |
| 700 | 1 | |a Hughes, Rod |e verfasserin |4 aut | |
| 700 | 1 | |a Agusti, Alvar |e verfasserin |4 aut | |
| 700 | 1 | |a Calverley, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Chipps, Bradley |e verfasserin |4 aut | |
| 700 | 1 | |a Del Olmo, Ricardo |e verfasserin |4 aut | |
| 700 | 1 | |a Papi, Alberto |e verfasserin |4 aut | |
| 700 | 1 | |a Price, David |e verfasserin |4 aut | |
| 700 | 1 | |a Reddel, Helen |e verfasserin |4 aut | |
| 700 | 1 | |a Müllerová, Hana |e verfasserin |4 aut | |
| 700 | 1 | |a Rapsomaniki, Eleni |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t American journal of respiratory and critical care medicine |d 1994 |g 209(2024), 4 vom: 15. Feb., Seite 390-401 |w (DE-627)NLM074657305 |x 1535-4970 |7 nnns |
| 773 | 1 | 8 | |g volume:209 |g year:2024 |g number:4 |g day:15 |g month:02 |g pages:390-401 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1164/rccm.202308-1436OC |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 209 |j 2024 |e 4 |b 15 |c 02 |h 390-401 | ||