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The paradoxical response to short-acting bronchodilator administration in patients with chronic obstructive pulmonary disease

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Abstract
Background: There are a few studies about paradoxical bronchodilator response (BDR), which means a decrease in forced expiratory volume in 1 second (FEV1) or forced vital capacity (FVC) after short-acting bronchodilator administration in patients with chronic obstructive pulmonary disease (COPD). We evaluated the effect of paradoxical BDR on the clinical outcomes of COPD patients in South Korea.

Methods: We analyzed the KOrea COpd Subgroup Study team (KOCOSS) cohort data in South Korea between January 2012 and December 2017. BDR was defined as at least a 12% and 200-mL reduction in FEV1 or FVC after bronchodilator administration.

Results: A total of 1,991 patients were included in this study. A paradoxical BDR was noted in 57 (2.9%) patients and was independently associated with worse dyspnea and poor quality of life. High C-reactive protein (CRP) levels were associated with a paradoxical BDR (OR, 1.05; 95% CI, 1.01-1.09; P=0.003). However, paradoxical BDR was not associated with severe acute exacerbations. Pre-bronchodilator FEV1 (L) showed a higher area under the curve (AUC) for predicting severe acute exacerbations than the postbronchodilator FEV1 (L) in the paradoxical BDR group (0.788 vs. 0.752).

Conclusion: A paradoxical reduction of FEV1 or FVC after bronchodilator administration may be associated with chronic inflammation in the airway and independently associated with worse respiratory symptoms and poor quality of life.
Author(s)
이재승Hong-Joon ShinHyun Kuk KimKi-Suck JungKOCOSS Cohort Study GroupKwang-Ha YooMin Kwang ByunSang-Hoon KimSung-Chul LimTae-Ok KimYong-Hyun KimYu-Il Kim
Issued Date
2021
Type
Article
Keyword
BronchodilatorC-reactive protein (CRP)chronic obstructive pulmonary disease (COPD)exacerbationparadoxical
DOI
10.21037/jtd-20-985
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7155
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2501478278&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,The%20paradoxical%20response%20to%20short-acting%20bronchodilator%20administration%20in%20patients%20with%20chronic%20obstructive%20pulmonary%20disease&offset=0&pcAvailability=true
Publisher
JOURNAL OF THORACIC DISEASE
Location
중국
Language
영어
ISSN
2072-1439
Citation Volume
13
Citation Number
2
Citation Start Page
511
Citation End Page
520
Appears in Collections:
Medicine > Medicine
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