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Bronchodilator responsiveness and future chronic airflow obstruction: a multinational longitudinal study

2025-03Journal article Open access
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datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorKnox-Brown, Ben
dc.contributor.authorAlgharbi, Fahad
dc.contributor.authorMulhern, Octavia
dc.contributor.authorPotts, James
dc.contributor.authorHarrabi, Imed
dc.contributor.authorJanson, Christer
dc.contributor.authorNielsen, Rune
dc.contributor.authorAgarwal, Dhiraj
dc.contributor.authorMalinovschi, Andrei
dc.contributor.authorJuvekar, Sanjay
dc.contributor.authorDenguezli, Miriam
dc.contributor.authorGíslason, Thorarinn
dc.contributor.authorAhmed, Rana
dc.contributor.authorNafees, Asaad
dc.contributor.authorKoul, Parvaiz A.
dc.contributor.authorObaseki, Daniel
dc.contributor.authorAnand, Mahesh Padukudru
dc.contributor.authorLoh, Li Cher
dc.contributor.authorHermínia Brites Dias
dc.contributor.authorRodrigues, Fátima
dc.contributor.authorMannino, David
dc.contributor.authorElbiaze, Mohammed
dc.contributor.authorEl Rhazi, Karima
dc.contributor.authorMejza, Filip
dc.contributor.authorDevereux, Graham
dc.contributor.authorFranssen, Frits
dc.contributor.authorEl Sony, Asma
dc.contributor.authorWouters, Emiel
dc.contributor.authorAl Ghobain, Mohammed
dc.contributor.authorMortimer, Kevin
dc.contributor.authorRashid, Abdul
dc.contributor.authorOsman, Rashid
dc.contributor.authorStudnicka, Michael
dc.contributor.authorCardoso, João
dc.contributor.authorBurney, Peter
dc.contributor.authorAmaral, André
dc.contributor.authorBOLD Collaborative Research Group
dc.date.accessioned2025-03-03T14:22:46Z
dc.date.available2025-03-03T14:22:46Z
dc.date.issued2025-03
dc.description.abstractBackground: Bronchodilator responsiveness testing is mainly used for diagnosing asthma. We aimed to investigate whether it is associated with progression to chronic airflow obstruction over time. Methods: The multinational Burden of Obstructive Lung Disease cohort study surveyed adults, aged 40 years and above, at baseline and followed them up after a mean of 9.1 years. Recruitment took place between January 2, 2003, and December 26, 2016. Follow-up measurements were collected between January 29, 2019, and October 24, 2021. On both occasions, study participants provided information on respiratory symptoms, health status, and several environmental and lifestyle exposures. They also underwent pre- and post-bronchodilator spirometry. We defined bronchodilator responsiveness at baseline using the American Thoracic Society and European Respiratory Society (ATS/ERS) 2022 definition, and the presence of chronic airflow obstruction at follow-up as a post-bronchodilator forced expiratory volume in 1 s to forced vital capacity ratio (FEV1/FVC) less than the lower limit of normal. We used multi-level regression models to estimate the association between baseline bronchodilator responsiveness and incident chronic airflow obstruction. We stratified analyses by gender and performed a sensitivity analysis in never smokers. Findings: We analysed data from 3701 adults with 56% being women. Compared to those without bronchodilator responsiveness at baseline, those with bronchodilator responsiveness had a 36% increased risk of developing chronic airflow obstruction (RR: 1.36, 95%CI 1.04, 1.80). This effect was stronger in women (RR: 1.45, 95%CI 1.09, 1.91) than in men (RR: 1.07, 95%CI 0.51, 2.24). Never smokers with bronchodilator responsiveness also were at greater risk of incident chronic airflow obstruction (RR: 1.48, 95%CI 1.01, 2.20). Interpretation: Bronchodilator responsiveness appears to be a risk factor for incident chronic airflow obstruction. It is important that future studies in other large population-based cohorts replicate these findings.eng
dc.identifier.citationKnox-Brown B, Algharbi F, Mulhern O, Potts J, Harrabi I, Dias HB, et al. Bronchodilator responsiveness and future chronic airflow obstruction: a multinational longitudinal study. eClin Med. 2025;81:103123.
dc.identifier.doi10.1016/j.eclinm.2025.103123
dc.identifier.issn2589-5370
dc.identifier.urihttp://hdl.handle.net/10400.21/21624
dc.language.isoeng
dc.peerreviewedyes
dc.publisherElsevier
dc.relation.hasversionhttps://www.sciencedirect.com/science/article/pii/S2589537025000550
dc.relation.ispartofeClinicalMedicine
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectSpirometry
dc.subjectAsthma
dc.subjectEpidemiology
dc.subjectCOPD
dc.subjectChronic obstructive pulmonary disease
dc.subjectBronchodilator
dc.titleBronchodilator responsiveness and future chronic airflow obstruction: a multinational longitudinal studyeng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.startPage103123
oaire.citation.titleEClinicalMedicine
oaire.citation.volume81
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameDias
person.givenNameMaria Hermínia Monteiro Brites
person.identifier.ciencia-idE211-FB1B-04E3
person.identifier.orcid0000-0003-1257-8734
person.identifier.ridAFL-8310-2022
person.identifier.scopus-author-id55671930200
relation.isAuthorOfPublicationb7b7e7d9-83b2-4d63-9176-4ed73cf6b939
relation.isAuthorOfPublication.latestForDiscoveryb7b7e7d9-83b2-4d63-9176-4ed73cf6b939

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