Abstract
Asthma and chronic obstructive pulmonary disease (COPD) are heterogeneous disorders encompassing different phenotypes of airflow obstruction, which might differ in their response to treatment. The aim of this study was to determine distinct phenotypes comprising the syndromes of asthma and COPD and the treatment responsiveness of these phenotypes to inhaled β-agonist, antimuscarinic, and corticosteroid therapy. We undertook a cross-sectional study with 3 phases. In phase 1, 1,264 participants aged 18 to 75 years with self-reported current wheeze and breathlessness were identified from a random population sample of 16,459. In phase 2, 451 participants attended for detailed assessment, including responsiveness to inhaled salbutamol and ipratropium bromide. In phase 3, 168 steroid-naive participants were enrolled in a 12-week trial of inhaled budesonide. Cluster analysis was performed in 389 participants who completed phase 2 with full data. Treatment responsiveness was compared between phenotypes. Cluster analysis identified 5 phenotypes: moderate-to-severe childhood-onset atopic asthma, asthma-COPD overlap, obese-comorbid, mild childhood-onset atopic asthma, and mild intermittent. Bronchodilation after salbutamol was equal to or...Continue Reading
References
May 1, 1990·Allergy·N E Eriksson
Jun 13, 2001·The European Respiratory Journal·S BaldacciM P Oryszczyn
Apr 16, 2004·The European Respiratory Journal·M MasoliR Beasley
Apr 9, 2005·American Journal of Respiratory and Critical Care Medicine·UNKNOWN American Thoracic Society, UNKNOWN European Respiratory Society
Apr 13, 2005·Respiratory Medicine·Elizabeth F JuniperElisabeth Ståhl
Aug 2, 2005·The European Respiratory Journal·M R MillerUNKNOWN ATS/ERS Task Force
Oct 22, 2005·Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology·A J WardlawR Green
Aug 29, 2006·Lancet·Sally E Wenzel
Nov 16, 2006·Thorax·Justin TraversRichard Beasley
Nov 23, 2006·Respiratory Medicine·Justin TraversRichard Beasley
Mar 16, 2007·Thorax·Mike BerryIan D Pavord
May 16, 2008·American Journal of Respiratory and Critical Care Medicine·Pranab HaldarRuth H Green
Sep 23, 2008·Lancet·Gary P Anderson
Mar 7, 2009·The New England Journal of Medicine·Pranabashis HaldarIan D Pavord
Apr 10, 2009·The European Respiratory Journal·M WeatherallR Beasley
Jul 30, 2009·Thorax·P G Gibson, J L Simpson
Sep 1, 2009·Lancet·Richard BeasleyPhilippa Shirtcliffe
Nov 7, 2009·American Journal of Respiratory and Critical Care Medicine·Wendy C MooreUNKNOWN National Heart, Lung, and Blood Institute's Severe Asthma Research Program
Oct 12, 2010·The European Respiratory Journal·M WeatherallR Beasley
Dec 24, 2010·Thorax·Judith Garcia-AymerichUNKNOWN PAC-COPD Study Group
Sep 2, 2011·The New England Journal of Medicine·Monica Kraft
Apr 3, 2012·The European Respiratory Journal·J TraversR Beasley
May 9, 2012·Nature Medicine·Sally E Wenzel
May 19, 2012·PloS One·E Rand SutherlandUNKNOWN Asthma Clinical Research Network
Aug 4, 2012·The Journal of Allergy and Clinical Immunology·Guiquan JiaUNKNOWN Bronchoscopic Exploratory Research Study of Biomarkers in Corticosteroid-refractory Asthma (BOBCAT) Study Group
Aug 21, 2012·Lancet·Ian D PavordPascal Chanez
Apr 18, 2013·American Journal of Respiratory and Critical Care Medicine·Dhananjay DesaiChris E Brightling
Jun 20, 2013·American Journal of Respiratory and Critical Care Medicine·Anne BoudierValérie Siroux
Jun 25, 2013·Thorax·Lowie E G W VanfleterenAlvar Agusti
Nov 5, 2013·American Journal of Respiratory and Critical Care Medicine·Mattia C F ProsperiAdnan Custovic
Citations
Dec 19, 2015·Expert Review of Respiratory Medicine·Neil C Thomson
Feb 8, 2016·The Journal of Allergy and Clinical Immunology·Timothy S C HinksPeter H Howarth
Jul 10, 2016·The Journal of Allergy and Clinical Immunology. in Practice·Claus Bachert, Cezmi A Akdis
Apr 5, 2016·Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology·K SekiyaH Tanaka
Aug 10, 2016·Allergy·D CaillaudUNKNOWN Initiatives BPCO scientific committee and investigators
Oct 27, 2016·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Tsutomu TamadaMasakazu Ichinose
Dec 13, 2016·The World Allergy Organization Journal·Giorgio Walter CanonicaGilda Varricchi
Aug 2, 2016·Journal of Primary Health Care·Linda Bryant
Dec 9, 2017·The European Respiratory Journal·James FingletonUNKNOWN NZ–China Study Group
Feb 27, 2016·The European Respiratory Journal·James FingletonUNKNOWN NZRHS Study Group
Feb 7, 2019·ERJ Open Research·Helen K ReddelJørgen Vestbo
Dec 31, 2015·Current Opinion in Pulmonary Medicine·Arthur F GelbJay A Nadel
Nov 2, 2019·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Joseph Emil AmegadzieZhiwei Gao
Jun 22, 2019·BMJ Open·Bright I NwaruBo Lundbäck
Jun 24, 2019·Allergy·Ilse M BoudewijnVictor Guryev
Sep 11, 2018·Expert Opinion on Pharmacotherapy·Neil C Thomson
Sep 4, 2019·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Smriti BhargavaPadukudru A Mahesh
Mar 12, 2017·Current Allergy and Asthma Reports·Kristin L Hines, R Stokes Peebles
Jun 22, 2017·Current Allergy and Asthma Reports·Hayley A ScottPeter G Gibson
Mar 3, 2018·PloS One·Iñigo OjangurenCatherine Lemiere
Jun 22, 2017·American Journal of Respiratory and Critical Care Medicine·Prescott G WoodruffRobert A Wise
Oct 20, 2017·Current Opinion in Pulmonary Medicine·James FingletonRichard Beasley
Jan 21, 2020·Expert Opinion on Pharmacotherapy·Timothy E AlbertsonSusan Murin
Feb 19, 2021·European Respiratory Review : an Official Journal of the European Respiratory Society·Xiaofan TuPhilip M Hansbro
May 1, 2021·Diagnostics·Francisco CunhaJoão A Fonseca
May 1, 2021·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Mindy K RossFrank D Gilliland
Oct 10, 2021·Chest·Clarus Leung, Don D Sin