Defining the Asthma-COPD Overlap Syndrome in a COPD Cohort

Asthma-COPD overlap syndrome (ACOS) has been recently described by international guidelines. A stepwise approach to diagnosis using usual features of both diseases is recommended although its clinical application is difficult. To identify patients with ACOS, a cohort of well-characterized patients w...

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Vydáno v:Chest Ročník 149; číslo 1; s. 45
Hlavní autoři: Cosio, Borja G, Soriano, Joan B, López-Campos, Jose Luis, Calle-Rubio, Myriam, Soler-Cataluna, Juan José, de-Torres, Juan P, Marín, Jose M, Martínez-Gonzalez, Cristina, de Lucas, Pilar, Mir, Isabel, Peces-Barba, Germán, Feu-Collado, Nuria, Solanes, Ingrid, Alfageme, Inmaculada, Casanova, Ciro
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 01.01.2016
Témata:
Aged
Asthma - complications
Asthma - diagnosis
Asthma - drug therapy
Bronchodilator Agents - therapeutic use
Cohort Studies
Eosinophils
Female
Forced Expiratory Volume
Humans
Leukocyte Count
Male
Middle Aged
Pulmonary Disease, Chronic Obstructive - complications
Pulmonary Disease, Chronic Obstructive - diagnosis
Pulmonary Disease, Chronic Obstructive - drug therapy
Syndrome
eosinophils
asthma
COPD
ISSN:1931-3543, 1931-3543
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Shrnutí:Asthma-COPD overlap syndrome (ACOS) has been recently described by international guidelines. A stepwise approach to diagnosis using usual features of both diseases is recommended although its clinical application is difficult. To identify patients with ACOS, a cohort of well-characterized patients with COPD and up to 1 year of follow-up was analyzed. We evaluated the presence of specific characteristics associated with asthma in this COPD cohort, divided into major criteria (bronchodilator test > 400 mL and 15% and past medical history of asthma) and minor criteria (blood eosinophils > 5%, IgE > 100 IU/mL, or two separate bronchodilator tests > 200 mL and 12%). We defined ACOS by the presence of one major criterion or two minor criteria. Baseline characteristics, health status (COPD Assessment Test [CAT]), BMI, airflow obstruction, dyspnea, and exercise capacity (BODE) index, rate of exacerbations, and mortality up to 1 year of follow-up were compared between patients with and without criteria for ACOS. Of 831 patients with COPD included,125 (15%) fulfilled the criteria for ACOS, and 98.4% of them sustained these criteria after 1 year. Patients with ACOS were predominantly male (81.6%), with symptomatic mild to moderate disease (67%), who were receiving inhaled corticosteroids (63.2%). There were no significant differences in baseline characteristics, and only survival was worse in patients with non-ACOS COPD after 1 year of follow-up (P < .05). The proposed ACOS criteria are present in 15% of a cohort of patients with COPD and these patients show better 1-year prognosis than clinically similar patients with COPD with no ACOS criteria. ClinicalTrials.gov; No.: NCT01122758; URL: www.clinicaltrials.gov.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1931-3543
1931-3543
DOI:10.1378/chest.15-1055