Bronchodilator Responsiveness in Tobacco-Exposed Persons with or without COPD

Spyridon Fortis; Pedro M Quibrera; Alejandro P Comellas; Surya P Bhatt; Donald P Tashkin; Eric A Hoffman; Gerard J Criner; MeiLan K Han; R Graham Barr; Mehrdad Arjomandi; Mark B Dransfield; Stephen P Peters; Brett A Dolezal; Victor Kim; Nirupama Putcha; Stephen I Rennard; Robert Paine; Richard E Kanner; Jeffrey L Curtis; Russell P Bowler; Fernando J Martinez; Nadia N Hansel; Jerry A Krishnan; Prescott G Woodruff; Igor Z Barjaktarevic; David Couper; Wayne H Anderson; Christopher B Cooper; Subpopulations and Intermediate Outcome Measures in COPD Study Investigators

doi:10.1016/j.chest.2022.11.009

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Bronchodilator Responsiveness in Tobacco-Exposed Persons with or without COPD

Journal article

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Bronchodilator Responsiveness in Tobacco-Exposed Persons with or without COPD

Spyridon Fortis, Pedro M Quibrera, Alejandro P Comellas, Surya P Bhatt, Donald P Tashkin, Eric A Hoffman, Gerard J Criner, MeiLan K Han, R Graham Barr, Mehrdad Arjomandi, …

Chest, Vol.163(3), pp.502-514

03/2023

DOI: 10.1016/j.chest.2022.11.009

PMCID: PMC9993341

PMID: 36395858

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Abstract

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 of 2,269 tobacco-exposed participants in SPIROMICS with or without COPD. We used various BDR definitions: change ≥200ml and ≥12% in FEV1 (FEV1-BDR), in FVC (FVC-BDR), and in FEV1 and/or FVC (ATS-BDR). Using generalized linear models adjusted for demographics, smoking history, post-bronchodilator FEV1 %predicted, and number of visits that the participant completed, we assess the association of BDR group: i) consistent BDR, ii) inconsistent BDR, and iii) never BDR with asthma, CT features, blood eosinophils, and FEV1 decline in participants without COPD (GOLD0) and the entire cohort (participants with or without COPD). RESULTS Both consistent and inconsistent ATS-BDR were associated with asthma history and greater small airway disease (%PRMfSAD) relative to never ATS-BDR in GOLD0 participants and the entire cohort. We observed similar findings using FEV1-BDR and FVC-BDR definitions. Eosinophils did not consistently vary between BDR groups. Consistent BDR was associated with FEV1 decline over time relative to never BDR in the entire cohort. In GOLD0, both inconsistent (OR=3.20;95%CI 2.21 to 4.66;P<0.001) and consistent ATS-BDR group (OR=9.48;95%CI 3.77 to 29.12;P<0.001) were associated with progression to COPD relative to never ATS-BDR group. INTERPRETATION Demonstration of BDR, even once, describes an obstructive lung disease phenotype with history of asthma, and greater small airway disease. Consistent demonstration of BDR indicates a high risk for lung function decline over time in the entire cohort and was associated with higher risk for progression to COPD in GOLD0.

Details

Title: Subtitle: Bronchodilator Responsiveness in Tobacco-Exposed Persons with or without COPD
Creators: Spyridon Fortis - Iowa City VA Health Care System
Pedro M Quibrera
Alejandro P Comellas
Surya P Bhatt
Donald P Tashkin
Eric A Hoffman
Gerard J Criner
MeiLan K Han
R Graham Barr
Mehrdad Arjomandi
Mark B Dransfield
Stephen P Peters
Brett A Dolezal
Victor Kim
Nirupama Putcha
Stephen I Rennard
Robert Paine
Richard E Kanner
Jeffrey L Curtis
Russell P Bowler
Fernando J Martinez
Nadia N Hansel
Jerry A Krishnan
Prescott G Woodruff
Igor Z Barjaktarevic
David Couper
Wayne H Anderson
Christopher B Cooper
Subpopulations and Intermediate Outcome Measures in COPD Study Investigators
Resource Type: Journal article
Publication Details: Chest, Vol.163(3), pp.502-514
DOI: 10.1016/j.chest.2022.11.009
PMID: 36395858
PMCID: PMC9993341
NLM abbreviation: Chest
ISSN: 0012-3692
eISSN: 1931-3543
Language: English
Electronic publication date: 11/14/2022
Date published: 03/2023
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Pulmonary, Critical Care, and Occupational Medicine; ICTS; Internal Medicine
Record Identifier: 9984320011202771

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