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- Title
Favorable longitudinal change of lung function in patients with asthma-COPD overlap from a COPD cohort.
- Authors
Park, Hye Yun; Lee, Suh-Young; Kang, Danbee; Cho, Juhee; Lee, Hyun; Lim, Seong Yong; Yoon, Ho Il; Ra, Seung Won; Kim, Ki Uk; Oh, Yeon-Mok; Sin, Don D.; Lee, Sang-Do; Park, Yong Bum
- Abstract
<bold>Background: </bold>The recognition of asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) as a distinct phenotype of COPD or asthma has increased. Although ACO has worse clinical features than non-ACO COPD, limited information is available on long-term outcomes of lung function decline for ACO and non-ACO COPD.<bold>Methods: </bold>COPD patients with at least 3 years of follow-up were selected from the Korean Obstructive Lung Disease cohort. ACO was defined based on 3 major criteria: 1) airflow limitation in individuals 40 years of age and older, 2) ≥10 pack-years of smoking history, and 3) a history of asthma or bronchodilator response of > 400 mL in forced expiratory volume in 1 s (FEV1) at baseline; and at least 1 minor criterion: 1) history of atopy or allergic rhinitis, 2) two separated bronchodilator responses of ≥12% and 200 mL in FEV1, or 3) peripheral blood eosinophils ≥300 cells/μL. Lung function decline was compared using a linear mixed effects model for longitudinal data with random intercept and random slope.<bold>Results: </bold>Among 239 patients, 47 were diagnosed with ACO (19.7%). During the follow-up period, change in smoking status, use of inhaled corticosteroids (ICS) and long-acting β2-agonists or ICS and at least 2 exacerbations per year were similar between patients with non-ACO COPD and ACO. Over a median follow-up duration of 5.8 years, patients with non-ACO COPD experienced a faster annual decline in pre-bronchodilator FEV1 than patients with ACO (- 29.3 ml/year vs. -13.9 ml/year, P = 0.042), which was persistent after adjustment for confounders affecting lung function decline.<bold>Conclusion: </bold>Patients with ACO showed favorable longitudinal changes in lung function compared to COPD patients over a median follow-up of 5.8 years.
- Subjects
OBSTRUCTIVE lung diseases; PULMONARY function tests; ASTHMA; DISEASE prevalence; RESPIRATORY diseases; ASTHMA diagnosis; OBSTRUCTIVE lung disease diagnosis; LUNG physiology; COMPARATIVE studies; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; RESEARCH; SPIROMETRY; EVALUATION research
- Publication
Respiratory Research, 2018, Vol 19, p1
- ISSN
1465-9921
- Publication type
journal article
- DOI
10.1186/s12931-018-0737-8