Abstract
Neither flow-related nor volume-related bronchodilator reversibility were independently associated with the symptom burden, health status or dyspnoea in the COPD population http://bit.ly/2rigD1r
From the authors:
We thank M.R. Miller for his comments on our paper regarding bronchodilator reversibility in asthma and COPD [1]. We agree that it is important to look at different ways of defining bronchodilator reversibility. In our analysis, we investigated both flow-related bronchodilator reversibility, defined by the change in forced expiratory volume in 1 s (FEV1), and volume-related bronchodilator reversibility, defined by the change in forced vital capacity. We also looked at both the change in lung function parameters expressed as percent of the baseline value and the change in FEV1 standardised by the subject's predicted value. The latter was evaluated to control for the sex, age and height dependency of lung function. The results when reversibility was expressed as percent of the predicted value (in supplementary tables E3 and E4) [1] were the same as when reversibility was expressed as percent of the baseline value. Our interpretation was therefore that, in the present study, neither flow-related nor volume-related bronchodilator reversibility were independently associated with the symptom burden, health status or dyspnoea in the COPD population.
It should be noted that our study was population-based and thus it may better reflect real life conditions, such as those encountered in general practice. However, we agree that cohort studies on patients, which include a higher number of subjects with a severe COPD, could yield different results that may be more applicable to decision-making in specialist practice. Furthermore, as our analysis was cross-sectional, we could not assess a possible association between bronchodilator responsiveness and prognosis over time. We therefore agree with M.R. Miller that further studies are needed before the respiratory community can dismiss testing of bronchodilator responsiveness in COPD.
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Supplementary Material
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Footnotes
Conflict of interest: C. Janson has nothing to disclose.
Conflict of interest: A. Malinovschi has nothing to disclose.
Conflict of interest: A.F.S. Amaral has nothing to disclose.
Conflict of interest: S. Accordini has nothing to disclose.
Conflict of interest: J. Bousquet reports personal fees and other funding from Chiesi, Cipla, Hikma, Menarini, Mundipharma, Mylan, Novartis, Sanofi-Aventis, Takeda, Teva and Uriach, and other funding from Kyomed, outside the submitted work.
Conflict of interest: A.S. Buist has nothing to disclose.
Conflict of interest: J. Garcia-Aymerich has nothing to disclose.
Conflict of interest: L. Gnatiuc has nothing to disclose.
Conflict of interest: W. Tan has nothing to disclose.
Conflict of interest: K. Torén has nothing to disclose.
Conflict of interest: T. Zuberbier has received consultancy fees from Bayer Health Care, FAES, Novartis and Henkel; has received grants/has grants pensing form Novartis and Henkel, and has received lecture fees from AstraZeneca, AbbVie, ALK, Almirall, Astellas, Bayer HealthCare, Bencradm Berlin Chemie, FAES, HAL, Leti, Meda, Menarini, Merck, MSD, Novartis, Pfizer, Sanofi, Stallergenes, Takeda, TEVA, UCB, Henkel, Kryolan and L'Oreal, outside the submitted work.
Conflict of interest: P. Burney has nothing to disclose.
- Received October 28, 2019.
- Accepted October 28, 2019.
- Copyright ©ERS 2019