@article{55dcb8539f354ba1892acb27da57fbd9,
title = "Worldwide patterns of bronchodilator responsiveness: Results from the Burden of Obstructive Lung Disease study",
abstract = "Rationale: Criteria for a clinically significant bronchodilator response (BDR) are mainly based on studies in patients with obstructive lung diseases. Little is known about the BDR in healthy general populations, and even less about the worldwide patterns. Methods: 10 360 adults aged 40 years and older from 14 countries in North America, Europe, Africa and Asia participated in the Burden of Obstructive Lung Disease study. Spirometry was used before and after an inhaled bronchodilator to determine the distribution of the BDR in population-based samples of healthy non-smokers and individuals with airflow obstruction. Results: In 3922 healthy never smokers, the weighted pooled estimate of the 95th percentiles (95% CI) for bronchodilator response were 284 ml (263 to 305) absolute change in forced expiratory volume in 1 s from baseline (ΔFEV1); 12.0% (11.2% to 12.8%) change relative to initial value (%ΔFEV1i); and 10.0% (9.5% to 10.5%) change relative to predicted value (%ΔFEV1p). The corresponding mean changes in forced vital capacity (FVC) were 322 ml (271 to 373) absolute change from baseline (ΔFVC); 10.5% (8.9% to 12.0%) change relative to initial value (ΔFVCi); and 9.2% (7.9% to 10.5%) change relative to predicted value (ΔFVCp). The proportion who exceeded the above threshold values in the subgroup with spirometrically defined Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 2 and higher (FEV1/FVC <0.7 and FEV1% predicted <80%) were 11.1%, 30.8% and 12.9% respectively for the FEV1-based thresholds and 22.6%, 28.6% and 22.1% respectively for the FVC-based thresholds. Conclusions: The results provide reference values for bronchodilator responses worldwide that confirm guideline estimates for a clinically significant level of BDR in bronchodilator testing.",
author = "Tan, {Wan C.} and Vollmer, {William M.} and Bernd Lamprecht and Mannino, {David M.} and Anamika Jithoo and Ewa Nizankowska-Mogilnicka and Filip Mejza and Thorarinn Gislason and Burney, {Peter G.J.} and Buist, {A. Sonia}",
note = "Funding Information: Funding The BOLD initiative has been funded in part by unrestricted educational grants to the Operations Center ( http://www.boldcopd.org ) from ALTANA, Aventis, AstraZeneca, Boehringer-Ingelheim, Chiesi, GlaxoSmithKline, Merck, Novartis, Pfizer, Schering-Plough, Sepracor, and University of Kentucky. Additional local support for BOLD clinical sites was provided by: Boehringer Ingelheim China (GuangZhou, China); Turkish Thoracic Society, Boehringer-Ingelheim, and Pfizer (Adana, Turkey); Altana, Astra-Zeneca, Boehringer-Ingelheim, GlaxoSmithKline, Merck Sharpe & Dohme, Novartis, Salzburger Gebietskrankenkasse, and Salzburg Local Government (Salzburg, Austria); Research for International Tobacco Control, the International Development Research Centre, the South African Medical Research Council, the South African Thoracic Society GlaxoSmithKline Pulmonary Research Fellowship, and the University of Cape Town Lung Institute (Cape Town, South Africa); and Landsp{\'i}tali-University Hospital-Scientific Fund, GlaxoSmithKline Iceland, and AstraZeneca Iceland (Reykjavik, Iceland); GlaxoSmithKline Pharmaceuticals, Polpharma, Ivax Pharma Poland, AstraZeneca Pharma Poland, ZF Altana Pharma, Pliva Kraki{\'o}w, Adamed, Novartis Poland, Linde Gaz Polska, Lek Polska, Tarchomi{\'n}skie Zak{\l}ady Farmaceutyczne Polfa, Starostwo Proszowice, Skanska, Zasada, Agencja Mienia Wojskowego w Krakowie, Telekomunikacja Polska, Biernacki, Biogran, Amplus Bucki, Skrzydlewski, Sotwin, and Agroplon (Cracow, Poland); Boehringer-Ingelheim, and Pfizer Germany (Hannover, Germany); the Norwegian Ministry of Health's Foundation for Clinical Research, and Haukeland University Hospital's Medical Research Foundation for Thoracic Medicine (Bergen, Norway); AstraZeneca, Boehringer-Ingelheim, Pfizer, and GlaxoSmithKline (Vancouver, Canada); Marty Driesler Cancer Project (Lexington, Kentucky, USA); Altana, Boehringer Ingelheim (Phil), GlaxoSmithKline, Pfizer, Philippine College of Chest Physicians, Philippine College of Physicians, and United Laboratories (Phil) (Manila, Philippines); Air Liquide Healthcare P/L, AstraZeneca P/L, Boehringer Ingelheim P/L, GlaxoSmithKline Australia P/L, Pfizer Australia P/L (Sydney, Australia); UK Department of Health's Policy Research Programme (London, UK); Swedish Heart-Lung Foundation, the Swedish Heart and Lung Association, and GlaxoSmithKline (Uppsala, Sweden). The sponsors of the study had no role in the study design, data collection, data analysis, data interpretation, or writing of the report. Funding Information: Competing interests WMV, ASB, TG, BL, ENM and WCT received funding for the BOLD study Operations Center and/or other research from unrestricted educational grants from GlaxoSmithKline, Pfizer, Boehringer Ingelheim, AstraZeneca, ALTANA, Novartis, Merck, Chiesi, Schering Plough, and Sepracor. Several authors have served on advisory boards for GlaxoSmithKline (ASB), ALTANA (ASB), Merck (ASB, WMV), Novartis (ASB). Several authors have participated in COPD workshops funded by Merck (WMV), AstraZeneca (ASB, TG), Pfizer (TG), GlaxoSmithKline (ASB, TG, WMV) and Telacris (WCT). All other authors declare they have no conflict of interest. ",
year = "2012",
month = aug,
doi = "10.1136/thoraxjnl-2011-201445",
language = "English (US)",
volume = "67",
pages = "718--726",
journal = "Thorax",
issn = "0040-6376",
publisher = "BMJ Publishing Group",
number = "8",
}