Bronchodilator response as a hallmark of uncontrolled asthma: a randomised clinical trial

Abstract

BD response can be used as a reliable measure of asthma control. This study suggests that ACQ5 scores alone are not sufficient to fully assess asthma control, and that BD response should be included as an essential measurement in any algorithm of asthma control evaluation.

The effects of oral corticosteroids on lung function, type-2 biomarkers and patient-reported outcomes in stable asthma: A systematic review and meta-analysis

“…[5,12] Higher sputum eosinophils were consistently associated with significantly greater OCS response in five studies. [5,6,13,16,17] Similarly, a strong statistically-significant positive association between blood eosinophils and OCS response was reported in three studies. [5,6,18] Higher baseline FeNO was also associated with a stronger OCS response in three studies [5,17,18], although one reported inconclusive results.…”

“…[5,11,15] In contrast, a single study reported a substantially higher mean baseline FEV1 among corticosteroid responders (74%) than non-responders (55%). [12] A lower FEV1/FVC ratio was associated with a stronger OCS response in two studies [5,13], with one reaching statistical significance. [5] Two studies reported that patients with greater bronchodilator reversibility exhibited a stronger OCS response [13,14], however a further two found little evidence of an effect.…”

“…[12] A lower FEV1/FVC ratio was associated with a stronger OCS response in two studies [5,13], with one reaching statistical significance. [5] Two studies reported that patients with greater bronchodilator reversibility exhibited a stronger OCS response [13,14], however a further two found little evidence of an effect. [5,12] Higher sputum eosinophils were consistently associated with significantly greater OCS response in five studies.…”

“…FEV1 was improved by 9% (95% CI: 7, 11). There were stronger increases in FEV1 among those with a mean baseline FEV1<60% predicted (19%, 95% CI: 13,24). Despite these improvements, substantial residual impairment remained after treatment.…”

“…Several studies (n=15) investigated the predictors of OCS response on FEV1. Six explored the effect of baseline FEV1 [5,[11][12][13][14][15], with most reporting negative associations [5,11,[13][14][15] including three that reached statistical significance. [5,11,15] In contrast, a single study reported a substantially higher mean baseline FEV1 among corticosteroid responders (74%) than non-responders (55%).…”