Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
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SHR Neuro Krebs Kardio Lipid Stoffw Microb
Milger, K; Skowasch, D; Hamelmann, E; Mümmler, C; Idzko, M; Gappa, M; Jandl, M; Körner-Rettberg, C; Ehmann, R; Schmidt, O; Taube, C; Holtdirk, A; Timmermann, H; Buhl, R; Korn, S.
Bronchodilator Reversibility in the GAN Severe Asthma Cohort.
J Investig Allergol Clin Immunol. 2023; 33(6):446-456
Doi: 10.18176/jiaci.0850
Web of Science
PubMed
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- Führende Autor*innen der Med Uni Graz
- Milger-Kneidinger Katrin
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- Abstract:
- BACKGROUND AND OBJECTIVE: Positive bronchodilator reversibility (BDR) is a diagnostic criterion for asthma. However, patients with asthma may exhibit a negative BDR response. Aim: To describe the frequency of positive and Negative BDR response in patients with severe asthma and study associations with phenotypic characteristics. METHODS: A positive BDR response was defined as an increase in FEV1 >200 mL and >12% upon testing with a short-acting ß-agonist. RESULTS: BDR data were available for 793 of the 2013 patients included in the German Asthma Net (GAN) severe asthma registry. Of these, 250 (31.5%) had a positive BDR response and 543 (68.5%) a egative BDR response. Comorbidities significantly associated with a negative response were gastroesophageal reflux disease (GERD) (28.0% vs 40.0%, P<.01) and eosinophilic granulomatosis with polyangiitis (0.4% vs 3.0%; P<.05), while smoking history (active: 2.8% vs 2.2%; ex: 40.0% vs 41.7%) and comorbid chronic obstructive pulmonary disease (COPD) (5.2% vs 7.2%) were similar in both groups. Patients with a positive BDR response had worse asthma control (median Asthma Control Questionnaire 5 score, 3.4 vs 3.0, P<.05), more frequently reported dyspnea at rest (26.8% vs 16.4%, P<.001) and chest tightness (36.4% vs 26.2%, P<.001), and had more severe airway obstruction at baseline (FEV1% predicted, 56 vs 64, P<.001) and higher fractional exhaled nitric oxide (FeNO) levels (41 vs 33 ppb, P<0.05). There were no differences in diffusion capacity of the lung for carbon monoxide, single breath (% pred, 70% vs 71%). Multivariate linear regression analysis identified an association between positive BDR response and lower baseline FEV1% (P<.001) and chest tightness (P<.05) and a negative association between BDR and GERD (P<.05). CONCLUSION: In this real-life setting, most patients with severe asthma had a negative BDR response. Interestingly, this was not associated with smoking history or COPD, but with lower FeNO and presence of GERD.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Bronchodilator Agents - therapeutic use
- Churg-Strauss Syndrome - administration & dosage
- Forced Expiratory Volume - physiology
- Granulomatosis with Polyangiitis - administration & dosage
- Asthma - diagnosis, drug therapy, epidemiology
- Pulmonary Disease, Chronic Obstructive - drug therapy
- Gastroesophageal Reflux - administration & dosage
- Find related publications in this database (Keywords)
- Bronchodilator responsiveness
- Severe asthma
- Real-life cohort
- GERD
- FeNO