Phenotyping asthma with airflow obstruction in middle-aged and older adults: a CADSET clinical research collaboration

Background: The prevalence and clinical profile of asthma with airflow obstruction (AO) remain uncertain. We aimed to phenotype AO in population- and clinic-based cohorts. Methods: This cross-sectional multicohort study included adults ≥50 years from nine CADSET cohorts with spirometry data (N=69 78...

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Autores: Bertels, Xander, García Aymerich, Judith, Lahousse, Lies
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/59404
Acceso en línea:http://hdl.handle.net/10230/59404
http://dx.doi.org/10.1136/bmjresp-2023-001760
Access Level:acceso abierto
Palabra clave:Asthma
Asthma epidemiology
COPD epidemiology
Clinical epidemiology
Pulmonary disease
Chronic obstructive
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spelling Phenotyping asthma with airflow obstruction in middle-aged and older adults: a CADSET clinical research collaborationBertels, XanderGarcía Aymerich, JudithLahousse, LiesAsthmaAsthma epidemiologyCOPD epidemiologyClinical epidemiologyPulmonary diseaseChronic obstructiveBackground: The prevalence and clinical profile of asthma with airflow obstruction (AO) remain uncertain. We aimed to phenotype AO in population- and clinic-based cohorts. Methods: This cross-sectional multicohort study included adults ≥50 years from nine CADSET cohorts with spirometry data (N=69 789). AO was defined as ever diagnosed asthma with pre-BD or post-BD FEV1/FVC <0.7 in population-based and clinic-based cohorts, respectively. Clinical characteristics and comorbidities of AO were compared with asthma without airflow obstruction (asthma-only) and chronic obstructive pulmonary disease (COPD) without asthma history (COPD-only). ORs for comorbidities adjusted for age, sex, smoking status and body mass index (BMI) were meta-analysed using a random effects model. Results: The prevalence of AO was 2.1% (95% CI 2.0% to 2.2%) in population-based, 21.1% (95% CI 18.6% to 23.8%) in asthma-based and 16.9% (95% CI 15.8% to 17.9%) in COPD-based cohorts. AO patients had more often clinically relevant dyspnoea (modified Medical Research Council score ≥2) than asthma-only (+14.4 and +14.7 percentage points) and COPD-only (+24.0 and +5.0 percentage points) in population-based and clinic-based cohorts, respectively. AO patients had more often elevated blood eosinophil counts (>300 cells/µL), although only significant in population-based cohorts. Compared with asthma-only, AO patients were more often men, current smokers, with a lower BMI, had less often obesity and had more often chronic bronchitis. Compared with COPD-only, AO patients were younger, less often current smokers and had less pack-years. In the general population, AO patients had a higher risk of coronary artery disease than asthma-only and COPD-only (OR=2.09 (95% CI 1.26 to 3.47) and OR=1.89 (95% CI 1.10 to 3.24), respectively) and of depression (OR=1.41 (95% CI 1.19 to 1.67)), osteoporosis (OR=2.30 (95% CI 1.43 to 3.72)) and gastro-oesophageal reflux disease (OR=1.68 (95% CI 1.06 to 2.68)) than COPD-only, independent of age, sex, smoking status and BMI. Conclusions: AO is a relatively prevalent respiratory phenotype associated with more dyspnoea and a higher risk of coronary artery disease and elevated blood eosinophil counts in the general population compared with both asthma-only and COPD-only.BMJ Publishing Group202420242023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/59404http://dx.doi.org/10.1136/bmjresp-2023-001760reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésBMJ Open Respir Res. 2023 Aug;10(1):e001760© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.http://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/594042026-06-12T07:21:37Z
dc.title.none.fl_str_mv Phenotyping asthma with airflow obstruction in middle-aged and older adults: a CADSET clinical research collaboration
title Phenotyping asthma with airflow obstruction in middle-aged and older adults: a CADSET clinical research collaboration
spellingShingle Phenotyping asthma with airflow obstruction in middle-aged and older adults: a CADSET clinical research collaboration
Bertels, Xander
Asthma
Asthma epidemiology
COPD epidemiology
Clinical epidemiology
Pulmonary disease
Chronic obstructive
title_short Phenotyping asthma with airflow obstruction in middle-aged and older adults: a CADSET clinical research collaboration
title_full Phenotyping asthma with airflow obstruction in middle-aged and older adults: a CADSET clinical research collaboration
title_fullStr Phenotyping asthma with airflow obstruction in middle-aged and older adults: a CADSET clinical research collaboration
title_full_unstemmed Phenotyping asthma with airflow obstruction in middle-aged and older adults: a CADSET clinical research collaboration
title_sort Phenotyping asthma with airflow obstruction in middle-aged and older adults: a CADSET clinical research collaboration
dc.creator.none.fl_str_mv Bertels, Xander
García Aymerich, Judith
Lahousse, Lies
author Bertels, Xander
author_facet Bertels, Xander
García Aymerich, Judith
Lahousse, Lies
author_role author
author2 García Aymerich, Judith
Lahousse, Lies
author2_role author
author
dc.subject.none.fl_str_mv Asthma
Asthma epidemiology
COPD epidemiology
Clinical epidemiology
Pulmonary disease
Chronic obstructive
topic Asthma
Asthma epidemiology
COPD epidemiology
Clinical epidemiology
Pulmonary disease
Chronic obstructive
description Background: The prevalence and clinical profile of asthma with airflow obstruction (AO) remain uncertain. We aimed to phenotype AO in population- and clinic-based cohorts. Methods: This cross-sectional multicohort study included adults ≥50 years from nine CADSET cohorts with spirometry data (N=69 789). AO was defined as ever diagnosed asthma with pre-BD or post-BD FEV1/FVC <0.7 in population-based and clinic-based cohorts, respectively. Clinical characteristics and comorbidities of AO were compared with asthma without airflow obstruction (asthma-only) and chronic obstructive pulmonary disease (COPD) without asthma history (COPD-only). ORs for comorbidities adjusted for age, sex, smoking status and body mass index (BMI) were meta-analysed using a random effects model. Results: The prevalence of AO was 2.1% (95% CI 2.0% to 2.2%) in population-based, 21.1% (95% CI 18.6% to 23.8%) in asthma-based and 16.9% (95% CI 15.8% to 17.9%) in COPD-based cohorts. AO patients had more often clinically relevant dyspnoea (modified Medical Research Council score ≥2) than asthma-only (+14.4 and +14.7 percentage points) and COPD-only (+24.0 and +5.0 percentage points) in population-based and clinic-based cohorts, respectively. AO patients had more often elevated blood eosinophil counts (>300 cells/µL), although only significant in population-based cohorts. Compared with asthma-only, AO patients were more often men, current smokers, with a lower BMI, had less often obesity and had more often chronic bronchitis. Compared with COPD-only, AO patients were younger, less often current smokers and had less pack-years. In the general population, AO patients had a higher risk of coronary artery disease than asthma-only and COPD-only (OR=2.09 (95% CI 1.26 to 3.47) and OR=1.89 (95% CI 1.10 to 3.24), respectively) and of depression (OR=1.41 (95% CI 1.19 to 1.67)), osteoporosis (OR=2.30 (95% CI 1.43 to 3.72)) and gastro-oesophageal reflux disease (OR=1.68 (95% CI 1.06 to 2.68)) than COPD-only, independent of age, sex, smoking status and BMI. Conclusions: AO is a relatively prevalent respiratory phenotype associated with more dyspnoea and a higher risk of coronary artery disease and elevated blood eosinophil counts in the general population compared with both asthma-only and COPD-only.
publishDate 2023
dc.date.none.fl_str_mv 2023
2024
2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/59404
http://dx.doi.org/10.1136/bmjresp-2023-001760
url http://hdl.handle.net/10230/59404
http://dx.doi.org/10.1136/bmjresp-2023-001760
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv BMJ Open Respir Res. 2023 Aug;10(1):e001760
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv BMJ Publishing Group
publisher.none.fl_str_mv BMJ Publishing Group
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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