Heterogeneity of asthma–chronic obstructive pulmonary disease (COPD) overlap from a cohort of patients with severe asthma and COPD
Background: A considerable proportion of patients have features of both asthma and chronic obstructive pulmonary disease (COPD) simultaneously, called asthma–COPD overlap (ACO). Objectives: The aim of this study was to identify heterogeneity of ACO from a cohort of patients with severe asthma and CO...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2023-04-01
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| Series: | Therapeutic Advances in Respiratory Disease |
| Online Access: | https://doi.org/10.1177/17534666231169472 |
| _version_ | 1797839254332637184 |
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| author | Joon Young Choi Chin Kook Rhee Kwang Ha Yoo Ki-Suck Jung Jae Ha Lee Hyoung Kyu Yoon Seung Won Ra Myung Goo Lee Yong Suk Jo |
| author_facet | Joon Young Choi Chin Kook Rhee Kwang Ha Yoo Ki-Suck Jung Jae Ha Lee Hyoung Kyu Yoon Seung Won Ra Myung Goo Lee Yong Suk Jo |
| author_sort | Joon Young Choi |
| collection | DOAJ |
| description | Background: A considerable proportion of patients have features of both asthma and chronic obstructive pulmonary disease (COPD) simultaneously, called asthma–COPD overlap (ACO). Objectives: The aim of this study was to identify heterogeneity of ACO from a cohort of patients with severe asthma and COPD using the same diagnostic criteria. Design: We used the International Severe Asthma Registry (ISAR) and the Korean COPD Subgroup Study (KOCOSS) to evaluate clinical characteristics of ACO from each cohort. Methods: We classified subjects into four groups: (1) pure severe asthma, (2) ACO from the severe asthma cohort, (3) ACO from the COPD cohort, and (4) pure COPD. ACO was defined by satisfying extreme bronchodilator response (BDR) >15% and 400 ml and/or blood eosinophil count ⩾300 /µL in patients aged 40 years or older and post-BD forced expiratory volume in 1 s (FEV 1 )/forced vital capacity (FVC) ratio <0.7. Results: The ACO group had 25 (23%) of 111 in the ISAR cohort and 403 (23%) of 1781 in the KOCOSS cohort. The ACO from the COPD cohort was older with more males and more smokers, but had similar degree of airflow limitation compared with the ACO from the severe asthma cohort. ICS-containing inhaler treatment was prescribed for all severe asthma subjects, but only for 43.9% of ACO subjects from the COPD cohort. Compared with patients having pure severe asthma, the risk for exacerbation was comparable in ACO either from severe asthma or COPD cohort [adjusted odds ratio (aOR): 1.54, 95% CI: 0.22–10.95 or aOR: 2.15, 95% CI: 0.59–7.85]. Conclusion: The prevalence of ACO was similar in severe asthma and COPD cohorts applying identical diagnostic criteria. ACO from the severe asthma cohort was similar to ACO from the COPD cohort in terms of lung function and exacerbation risk. |
| first_indexed | 2024-04-09T15:55:01Z |
| format | Article |
| id | doaj.art-521ea24b7f684cf9998e0c9770dede81 |
| institution | Directory Open Access Journal |
| issn | 1753-4666 |
| language | English |
| last_indexed | 2024-04-09T15:55:01Z |
| publishDate | 2023-04-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Respiratory Disease |
| spelling | doaj.art-521ea24b7f684cf9998e0c9770dede812023-04-25T17:34:06ZengSAGE PublishingTherapeutic Advances in Respiratory Disease1753-46662023-04-011710.1177/17534666231169472Heterogeneity of asthma–chronic obstructive pulmonary disease (COPD) overlap from a cohort of patients with severe asthma and COPDJoon Young ChoiChin Kook RheeKwang Ha YooKi-Suck JungJae Ha LeeHyoung Kyu YoonSeung Won RaMyung Goo LeeYong Suk JoBackground: A considerable proportion of patients have features of both asthma and chronic obstructive pulmonary disease (COPD) simultaneously, called asthma–COPD overlap (ACO). Objectives: The aim of this study was to identify heterogeneity of ACO from a cohort of patients with severe asthma and COPD using the same diagnostic criteria. Design: We used the International Severe Asthma Registry (ISAR) and the Korean COPD Subgroup Study (KOCOSS) to evaluate clinical characteristics of ACO from each cohort. Methods: We classified subjects into four groups: (1) pure severe asthma, (2) ACO from the severe asthma cohort, (3) ACO from the COPD cohort, and (4) pure COPD. ACO was defined by satisfying extreme bronchodilator response (BDR) >15% and 400 ml and/or blood eosinophil count ⩾300 /µL in patients aged 40 years or older and post-BD forced expiratory volume in 1 s (FEV 1 )/forced vital capacity (FVC) ratio <0.7. Results: The ACO group had 25 (23%) of 111 in the ISAR cohort and 403 (23%) of 1781 in the KOCOSS cohort. The ACO from the COPD cohort was older with more males and more smokers, but had similar degree of airflow limitation compared with the ACO from the severe asthma cohort. ICS-containing inhaler treatment was prescribed for all severe asthma subjects, but only for 43.9% of ACO subjects from the COPD cohort. Compared with patients having pure severe asthma, the risk for exacerbation was comparable in ACO either from severe asthma or COPD cohort [adjusted odds ratio (aOR): 1.54, 95% CI: 0.22–10.95 or aOR: 2.15, 95% CI: 0.59–7.85]. Conclusion: The prevalence of ACO was similar in severe asthma and COPD cohorts applying identical diagnostic criteria. ACO from the severe asthma cohort was similar to ACO from the COPD cohort in terms of lung function and exacerbation risk.https://doi.org/10.1177/17534666231169472 |
| spellingShingle | Joon Young Choi Chin Kook Rhee Kwang Ha Yoo Ki-Suck Jung Jae Ha Lee Hyoung Kyu Yoon Seung Won Ra Myung Goo Lee Yong Suk Jo Heterogeneity of asthma–chronic obstructive pulmonary disease (COPD) overlap from a cohort of patients with severe asthma and COPD Therapeutic Advances in Respiratory Disease |
| title | Heterogeneity of asthma–chronic obstructive pulmonary disease (COPD) overlap from a cohort of patients with severe asthma and COPD |
| title_full | Heterogeneity of asthma–chronic obstructive pulmonary disease (COPD) overlap from a cohort of patients with severe asthma and COPD |
| title_fullStr | Heterogeneity of asthma–chronic obstructive pulmonary disease (COPD) overlap from a cohort of patients with severe asthma and COPD |
| title_full_unstemmed | Heterogeneity of asthma–chronic obstructive pulmonary disease (COPD) overlap from a cohort of patients with severe asthma and COPD |
| title_short | Heterogeneity of asthma–chronic obstructive pulmonary disease (COPD) overlap from a cohort of patients with severe asthma and COPD |
| title_sort | heterogeneity of asthma chronic obstructive pulmonary disease copd overlap from a cohort of patients with severe asthma and copd |
| url | https://doi.org/10.1177/17534666231169472 |
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