Airway responsiveness to methacholine and incidence of COPD: an international prospective cohort study

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• dc.contributor.author Marcon, Alessandro
• dc.contributor.author Fuertes, Elaine
• dc.contributor.author García Aymerich, Judith
• dc.contributor.author Ageing Lungs In European Cohorts study
• dc.date.accessioned 2020-02-20T08:26:10Z
• dc.date.available 2020-02-20T08:26:10Z
• dc.date.issued 2018
• dc.description.abstract Background: It has been debated, but not yet established, whether increased airway responsiveness can predict COPD. Recognising this link may help in identifying subjects at risk. Objective: We studied prospectively whether airway responsiveness is associated with the risk of developing COPD. Methods: We pooled data from two multicentre cohort studies that collected data from three time points using similar methods (European Community Respiratory Health Survey and Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults). We classified subjects (median age 37 years, 1st-3rd quartiles: 29-44) by their level of airway responsiveness using quintiles of methacholine dose-response slope at the first examination (1991-1994). Then, we excluded subjects with airflow obstruction at the second examination (1999-2003) and analysed incidence of COPD (postbronchodilator FEV1/FVC below the lower limit of normal) at the third examination (2010-2014) as a function of responsiveness, adjusting for sex, age, education, body mass index, history of asthma, smoking, occupational exposures and indicators of airway calibre. Results: We observed 108 new cases of COPD among 4205 subjects during a median time of 9 years. Compared with the least responsive group (incidence rate 0.6 per 1000/year), adjusted incidence rate ratios for COPD ranged from 1.79 (95% CI 0.52 to 6.13) to 8.91 (95% CI 3.67 to 21.66) for increasing airway responsiveness. Similar dose-response associations were observed between smokers and non-smokers, and stronger associations were found among subjects without a history of asthma or asthma-like symptoms. Conclusions: Our study suggests that increased airway responsiveness is an independent risk factor for COPD. Further research should clarify whether early treatment in patients with high responsiveness can slow down disease progression.
• dc.description.sponsorship The ALEC Study is funded by the European Union’s Horizon 2020 Research and Innovation programme under grant agreement no. 633212. ISGlobal is a member of the CERCA Programme, Generalitat de Catalunya. The SAPALDIA cohort has been funded since 1991 primarily by the Swiss National Science Foundation (grants no 33CS30-148470/1&2, 33CSCO-134276/1, 33CSCO-108796, 324730_135673, 3247BO-104283, 3247BO-104288, 3247BO-104284, 3247-065896, 3100-059302, 3200-052720, 3200-042532, 4026-028099, PMPDP3_129021/1, PMPDP3_141671/1). Other national funders who supported data collection in the original studies are listed in the supplement.
• dc.format.mimetype application/pdf
• dc.identifier.citation Marcon A, Locatelli F, Keidel D, Beckmeyer-Borowko AB, Cerveri I, Dharmage SC et al. Airway responsiveness to methacholine and incidence of COPD: an international prospective cohort study. Thorax. 2018;73(9):825-32. DOI: 10.1136/thoraxjnl-2017-211289
• dc.identifier.doi http://dx.doi.org/10.1136/thoraxjnl-2017-211289
• dc.identifier.issn 0040-6376
• dc.identifier.uri http://hdl.handle.net/10230/43672
• dc.language.iso eng
• dc.publisher BMJ Publishing Group
• dc.relation.ispartof Thorax. 2018;73(9):825-32
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/633212
• dc.rights © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. 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 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 Clinical epidemiology
• dc.subject.keyword Copd epidemiology
• dc.title Airway responsiveness to methacholine and incidence of COPD: an international prospective cohort study
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion