DocWire News Editors

DocwireNews

A study being presented at the CHEST Annual Meeting 2019 found that routine use of post-bronchodilator spirometry values prevents the overdiagnosis of chronic obstructive pulmonary disease (COPD) and better identifies patients with asthma-COPD overlap syndrome (ACOS).Researchers used data from the National Health and Nutrition Examination Survey III from 2007 to 2012 to identify patients aged &ge;40 years with spirometry studies meeting the American Thoracic Society (ATS) quality standards. Researchers used eosinophil count &ge;300 cells/&mu;L and forced expiratory volume in one second (FEV1) change &gt;12% and &gt;200 mL with bronchodilator testing to define blood eosinophilia and bronchodilator reversibility, respectively.Probable ACOS was defined with two major criteria: post-bronchodilator FEV1/forced vital capacity (FVC) &lt;0.7 in cases with an asthma history or FEV1 change &ge;400 mL in cases without an asthma history, as well as one minor criteria: bronchodilator reversibility or blood eosinophilia. Probable asthma cases were considered a post-bronchodilator FEV1/FVC &ge;0.7 with bronchodilator reversibility and/or blood eosinophilia. Patients self-identified whether they had received an asthma diagnosis from a healthcare professional.The study included 8,002 patients who completed pre-bronchodilator spirometry testing, 625 of whom met the ATS spirometry quality standards and had a pre-bronchodilator FEV1/FVC &lt;0.7. Among these patients, 381 (61%) had a post-bronchodilator FEV1/FVC &lt;0.7, 12 (3.1%) had a history of asthma and bronchodilator reversibility, 16 (4.2%) had a history of asthma and blood eosinophilia, and two (0.7%) had FEV1 change &ge;400 mL and blood eosinophilia, making ACOS more likely than COPD alone in these patients.The remaining 39% of cases (n=244) had a pre-bronchodilator FEV1/FVC &lt;0.7 but post-bronchodilator &ge;0.7 and may be overdiagnosed as having COPD; 24 patients (9.8%) had bronchodilator reversibility alone, while 10 had bronchodilator reversibility and eosinophilia, making asthma more likely.Eighteen of the 24 patients with bronchodilator reversibility and six of 10 with bronchodilator reversibility and eosinophilia had no prior history of asthma and would likely be misdiagnosed with COPD if just the pre-bronchodilator FEV1/FVC ratio was considered.&ldquo;Post-bronchodilator spirometry values, along with the recommended criteria for ACOS help identify 8% of COPD [patients] who likely have ACOS,&rdquo; the authors concluded.ReferenceAnnangi S, Yataco AC. Role of bronchodilator testing in identifying COPD, asthma, and asthma-COPD overlap syndrome: NHANES III analysis. Presented at the CHEST Annual Meeting 2019. October 19-23, 2019; New Orleans, Louisiana.

BMI Modifies the Relationship Between Glycemic Status and Asthma Severity in Children

Asthma

Jordana Jampel

Cutaneous Melanoma: Sun Protection Behaviors and UV Exposure in Canada

Melanoma

Leah Lawrence

Significant Cardiac Benefit Seen With Ifetroban in Patients With Duchenne Muscular Dystrophy

Neurology

Latest News

Bronchodilator Testing May Better Diagnose Asthma-COPD Overlap Syndrome

CHEST 2019 Conference Coverage

A study being presented at the CHEST Annual Meeting 2019 found that routine use of post-bronchodilator spirometry values prevents the overdiagnosis of chronic obstructive ...

About Us

Editorial Policy

Advertising

Contact Us

eNewsletters

Contribute

Career Center

MashupMD

Blood Cancers Today

Cancer Nursing Today

GU Oncology Now

Urban Health Today

Anemia

Deep Vein Thrombosis

Essential Thrombocythemia

Hemophilia

Immune Thrombocytopenic Purpura

Myelodysplastic Syndromes

Myelofibrosis

Myeloproliferative Neoplasms

Polycythemia Vera

Pulmonary Embolism

Sickle Cell Disease

Thrombocytopenia

Thrombophilia

Thrombosis

Thrombotic Thrombocytopenic Purpura

Venous Thromboembolism

von Willebrand Disease

Heme Today

Acute Kidney Injury

ADPKD

Anemia and Kidney Disease

Chronic Kidney Disease

COVID-19 and Kidney Disease

Diabetes and Hypertension

End-Stage Renal Disease

Gout

Hyperkalemia

IgAN

Kidney Transplantation

Metabolic Acidosis

Nephrology Times

HER2 Breast Cancer

HR Breast Cancer

Triple-Negative Breast Cancer

Genetics & Breast Cancer

Breast Cancers Today

Atherosclerotic Disease

Atrial Fibrillation

Heart Failure

Hypertension

Interventional Cardiology

Lipid Management

Practice Tips With Dr. Lichaa

Preventive Cardiology

Stroke

Cardiology

Breast Cancer

Gynecologic Cancer

Head and Neck Cancer

Skin Cancer

Oncology

Sleep

Urology

Diabetes

Ophthalmology

— Demodex Blepharitis

Rheumatology

Gastroenterology

Pulmonology

Infectious Diseases

— HIV

Health and Wellness

Lupus

Future of Medicine

Orthopedics

Pharmacology

Career News

More

Conferences

CardioNerds

The Sleep Source With Dr. Morse

Rheumatology Rounds With Dr. Maheswaranathan

Partners

Expert Interviews

Subscribe