Phenotyping asthma with airflow obstruction in middle-aged and older adults: a CADSET Clinical Research Collaboration

Asthma with airflow obstruction

Background "Phenotyping asthma with airflow obstruction in middle-aged and older adults"

Asthma with fixed airflow obstruction (AFO) is associated with higher exacerbation rates and mortality compared to non-obstructed asthma, yet its prevalence and clinical profile remain uncertain.


We aimed to determine the prevalence, characteristics, and comorbidities of asthma with airflow obstruction in adults ≥50 years.


Participants with spirometry data from 9 CADSET cohorts (n=69,789) were cross-sectionally analyzed. In 2 asthma- and 4 COPD cohorts, AFO was defined as ever diagnosed asthma with post-BD FEV1/FVC<0.7. In 3 population cohorts, AFO was defined as ever asthma with pre-BD FEV1/FVC<0.7. The prevalence and co-morbidities of AFO were meta-analyzed and characteristics were compared to asthma without airflow obstruction (asthma-only) and COPD without asthma history (COPD-only).


The prevalence of AFO was 2.2% (95%CI: 1.8-2.6%) in the general population, 21.0% (18.5-23.8%) in asthma cohorts and 9.9% (5.0-18.7%) in COPD cohorts. AFO patients reported significantly more dyspnea than asthma- and COPD-only. Compared to asthma-only, AFO were older, more often male, current smokers, had lower BMI, and had higher white blood cell counts, yet showed no significant difference in co-morbidities. Compared to COPD-only, AFO were younger, more often female, never smokers, had higher BMI and had more often depression (24.5 vs 11.5%, p=0.01), osteoporosis (21.8 vs 13.4%, p<0.01), and gastro-esophageal reflux disease (GERD; 36.6 vs 24.7%, p<0.01).


AFO is a prevalent respiratory phenotype associated with more dyspnea than asthma- and COPD-only. AFO patients had more depression, osteoporosis, and GERD compared to COPD-only.


Xander Bertels, Ahmed Edris, Judith Garcia-Aymerich, Rosa Faner, Howraman Meteran, Torben Sigsgaard, Peter Alter, Claus Vogelmeier, Núria Olvera, Nazanin Zounemat-Kermani, Alvar Agusti, Gavin Donaldson, Jadwiga Wedzicha, Guy Brusselle, Helena Backman, Eva Rönmark, Anne Lindberg, Judith Vonk, Kian Fan Chung, Ian Adcock, Maarten Van Den Berge, Lies Lahousse

Read more

Noticias relacionadas


Imagen obtenida en Canva Pro.

Entérate de
Nuestras Publicaciones