Bronchodilator Responsiveness Defined by the 2005 and 2021 ERS/ATS Criteria in Patients with Asthma as Well as Chronic Obstructive Pulmonary Disease

• DOI: 10.2147/copd.s385733
• Publication Date: 2022-10-17T10:45:13Z
• Authors: Yun Li; Junfeng Lin; Zihui Wang; Zhufeng Wang; Lunfang Tan; Shuyi Liu; Jinhai Huang; Yi Gao; Jinping Zheng
• Keywords: RC705-779; Vital Capacity; International Journal of Chronic Obstructive Pulmonary Disease; asthma; Severity of Illness Index; european respiratory society (ers); Asthma; american thoracic society (ats); Bronchodilator Agents; 3. Good health; bronchodilator responsiveness testing; Diseases of the respiratory system; Pulmonary Disease, Chronic Obstructive; 03 medical and health sciences; pulmonary function test; 0302 clinical medicine; Forced Expiratory Volume; Humans; chronic obstruc-tive pulmonary disease; Original Research

In the 2021 ERS/ATS interpretive strategies for routine lung function tests, a positive bronchodilator response (BDR) was updated as a change of >10% relative to the predicted value in forced expiratory volume in 1 second (FEV1) or forced vital capacity (FVC). We aimed to explore the differences between the 2005 and 2021 ERS/ATS criteria applied to patients with asthma as well as chronic obstructive pulmonary disease (COPD).BDR test data about asthma patients aged 6-80 years and COPD patients aged 18-80 years were derived from the National Respiratory Medicine Center, First Affiliated Hospital of Guangzhou Medical University, from January 2017 to March 2022. BDR results defined by the 2005 and 2021 ERS/ATS criteria were named 2005-BDR and 2021-BDR, respectively. We compared differences between 2005-BDR and 2021-BDR and analyzed the trend in the proportion of positive BDR (BDR+) with the level of airflow obstruction.A total of 4457 patients with asthma and 7764 patients with COPD were included in the analysis. The percentages of 2005-BDR+ and 2021-BDR+ were 63.32% and 52.84% for asthma, 30.92% and 22.94% for COPD, respectively. Of patients with 2005-BDR+, 81.86% for asthma and 70.18% for COPD showed 2021-BDR+ results, and these patients had higher FEV1%pred, FVC%pred (all P<0.05). Whichever BDR criterion was adopted, the proportion of BDR+ had an upward linear trend with the increased degree of airflow obstruction in COPD, but exhibited an approximate inverted U-shaped curve in asthma. In COPD, the proportion of BDRFEV1 was negatively associated with the degree of airflow obstruction, while BDRFVC was positively associated (all P<0.05).Compared with 2005-BDR+, the proportion of 2021-BDR+ reduced markedly in patients with asthma and COPD, but their trends with the degree of airflow obstruction did not change. Patients with consistent BDR+ had higher initial FEV1%pred and FVC%pred.