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

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  • dc.contributor.author Bertels, Xander
  • dc.contributor.author García Aymerich, Judith
  • dc.contributor.author Lahousse, Lies
  • dc.date.accessioned 2024-03-13T15:59:17Z
  • dc.date.available 2024-03-13T15:59:17Z
  • dc.date.issued 2023
  • dc.description.abstract 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.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Bertels X, Edris A, Garcia-Aymerich J, Faner R, Meteran H, Sigsgaard T et al. Phenotyping asthma with airflow obstruction in middle-aged and older adults: a CADSET clinical research collaboration. BMJ Open Respir Res. 2023 Aug;10(1):e001760. DOI: 10.1136/bmjresp-2023-001760
  • dc.identifier.doi http://dx.doi.org/10.1136/bmjresp-2023-001760
  • dc.identifier.issn 2052-4439
  • dc.identifier.uri http://hdl.handle.net/10230/59404
  • dc.language.iso eng
  • dc.publisher BMJ Publishing Group
  • dc.relation.ispartof BMJ Open Respir Res. 2023 Aug;10(1):e001760
  • dc.rights © 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/.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by-nc/4.0/
  • dc.subject.keyword Asthma
  • dc.subject.keyword Asthma epidemiology
  • dc.subject.keyword COPD epidemiology
  • dc.subject.keyword Clinical epidemiology
  • dc.subject.keyword Pulmonary disease
  • dc.subject.keyword Chronic obstructive
  • dc.title Phenotyping asthma with airflow obstruction in middle-aged and older adults: a CADSET clinical research collaboration
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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Articles (Barcelona Institute for Global Health (ISGlobal) – Campus Mar)