@article{01H9J7PXXRK4T784F95QN0S5XJ,
  abstract     = {{Background The prevalence and clinical profile of asthma with airflow obstruction (AO) remain uncertain. We aimed to phenotype AO in population- and clinic-based cohorts.

Methods This cross-sectional multicohort study included adults = 50 years from nine CADSET cohorts with spirometry data (N=69 789). AO was defined as ever diagnosed asthma with pre-BD or post-BD FEV1/FVC <0.7 in population-based and clinic-based cohorts, respectively. Clinical characteristics and comorbidities of AO were compared with asthma without airflow obstruction (asthma-only) and chronic obstructive pulmonary disease (COPD) without asthma history (COPD-only). ORs for comorbidities adjusted for age, sex, smoking status and body mass index (BMI) were meta-analysed using a random effects model.

Results The prevalence of AO was 2.1% (95% CI 2.0% to 2.2%) in population-based, 21.1% (95% CI 18.6% to 23.8%) in asthma-based and 16.9% (95% CI 15.8% to 17.9%) in COPD-based cohorts. AO patients had more often clinically relevant dyspnoea (modified Medical Research Council score >= 2) than asthma-only (+14.4 and +14.7 percentage points) and COPD-only (+24.0 and +5.0 percentage points) in population-based and clinic-based cohorts, respectively. AO patients had more often elevated blood eosinophil counts (>300 cells/mu L), although only significant in population-based cohorts. Compared with asthma-only, AO patients were more often men, current smokers, with a lower BMI, had less often obesity and had more often chronic bronchitis. Compared with COPD-only, AO patients were younger, less often current smokers and had less pack-years. In the general population, AO patients had a higher risk of coronary artery disease than asthma-only and COPD-only (OR=2.09 (95% CI 1.26 to 3.47) and OR=1.89 (95% CI 1.10 to 3.24), respectively) and of depression (OR=1.41 (95% CI 1.19 to 1.67)), osteoporosis (OR=2.30 (95% CI 1.43 to 3.72)) and gastro-oesophageal reflux disease (OR=1.68 (95% CI 1.06 to 2.68)) than COPD-only, independent of age, sex, smoking status and BMI.

Conclusions AO is a relatively prevalent respiratory phenotype associated with more dyspnoea and a higher risk of coronary artery disease and elevated blood eosinophil counts in the general population compared with both asthma-only and COPD-only.}},
  articleno    = {{e001760}},
  author       = {{Bertels, Xander and Edris Mohamed, Ahmed and Garcia-Aymerich, Judith and Faner, Rosa and Meteran, Howraman and Sigsgaard, Torben and Alter, Peter and Vogelmeier, Claus and Olvera, Nuria and Kermani, Nazanin Zounemat and Agusti, Alvar and Donaldson, Gavin C and Wedzicha, Jadwiga A and Brusselle, Guy and Backman, Helena and Rönmark, Eva and Lindberg, Anne and Vonk, Judith M and Chung, Kian Fan and Adcock, Ian M and van den Berge, Maarten and Lahousse, Lies}},
  issn         = {{2052-4439}},
  journal      = {{BMJ OPEN RESPIRATORY RESEARCH}},
  keywords     = {{Pulmonary and Respiratory Medicine,Clinical Epidemiology,Asthma,Pulmonary Disease, Chronic Obstructive,COPD epidemiology,Asthma Epidemiology}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{9}},
  publisher    = {{BMJ}},
  title        = {{Phenotyping asthma with airflow obstruction in middle-aged and older adults : a CADSET clinical research collaboration}},
  url          = {{http://doi.org/10.1136/bmjresp-2023-001760}},
  volume       = {{10}},
  year         = {{2023}},
}

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