PT  - JOURNAL ARTICLE
AU  - Luis Pérez de Llano
AU  - Francisco Carballada
AU  - Juan Luis García-Rivero
AU  - Isabel Urrutia
AU  - Eva Martínez-Moragón
AU  - Marina Blanco
AU  - Jacinto Ramos
AU  - Maria Carmen Vennera
AU  - Vicente Plaza
AU  - Pilar Cebollero
AU  - María Merino
TI  - Positive bronchodilator response is a poor predictor of future risk in well controlled asthma patients
AID  - 10.1183/13993003.congress-2016.PA4129
DP  - 2016 Sep 01
TA  - European Respiratory Journal
PG  - PA4129
VI  - 48
IP  - suppl 60
4099  - http://erj.ersjournals.com/content/48/suppl_60/PA4129.short
4100  - http://erj.ersjournals.com/content/48/suppl_60/PA4129.full
SO  - Eur Respir J2016 Sep 01; 48
AB  - This study was aimed to determine the ability of a positive bronchodilator response (BDR) to predict asthma loss of control in a real-life setting.Material and methods: Prospective, multicenter study. Treatment was stepped-up or stepped-down over a 12-month period to maintain asthma control. Patients who were well-controlled at baseline with a combination of inhaled corticosteroid and long-acting β2 agonist (IC/LABA) were included. A BDT was performed at each visit (3, 6 and 12 months) and loss of control was assessed.Results: 149 patients were included (70% women, mean age 54.7 years). At baseline, mean FEV1 was 92.1%, mean Asthma Control Test score was 23.0 ± 2.1 and the exacerbation rate was 0.4 ± 0.8 per patient-year. 344 BDR measurements were made (always positive in 8.3% of the patients, intermittently positive in 41.3% and always negative in 50.4%). 59 patients (40%) lost control over the study. The area under the ROC curve of a positive BDR was 0.52 (95% CI: 0.44-0.60). Sensitivity was 23% (95% CI: 13-34%), specificity was 81% (95% CI: 76-86%), positive predictive value was 22% (95% CI: 12-32%), negative predictive value was 82% (95% CI: 78-87%), positive likelihood ratio was 1.24 (95% CI: 0.75-2.05) and negative likelihood ratio was 0.94 (95% CI: 0.82-1.09). Conclusions: A positive BDR does not predict future risk in asthma and lacks a clinical justification for its routine use.