Increased risk of exacerbation in asthma predominant asthma-chronic obstructive pulmonary disease overlap syndrome

Jisoo Park, Eun Kyung Kim, Mi Ae Kim, Tae Hyung Kim, Jung Hyun Chang, Yon Ju Ryu, Sei Won Lee, Yeon Mok Oh, Suk Joong Yong, Won Il Choi, Kwang Ha Yoo, Ji Hyun Lee

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Obstructive airway disease patients with increased variability of airflow and incompletely reversible airflow obstruction are often categorized as having asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS). ACOS is heterogeneous with two sub-phenotypes: asthma-ACOS and COPD-ACOS. The objective of this study was to determine the difference in risk of exacerbation between the two sub-phenotypes of ACOS. Methods: A total of 223 patients exhibiting incompletely reversible airflow obstruction with increased variability (spirometrically defined ACOS) were enrolled. These patients were divided into asthma-ACOS and COPD-ACOS according to their physician's diagnosis and smoking history of 10 pack-years. Within-group comparisons were made for asthma-ACOS versus COPD-ACOS and light smokers versus heavy smokers. Results: Compared to patients with COPD-ACOS, patients with asthma-ACOS experienced exacerbation more often despite their younger age, history of light smoking, and better lung function. While the light-smoking group showed better lung function, they made unscheduled outpatient clinic visits more frequently. On multivariate analysis, asthma-ACOS and poor inhaler compliance were significantly associated with more than two unscheduled clinic visits during the previous year. Conclusion: Spirometrically defined ACOS includes heterogeneous subgroups with different clinical features. Phenotyping of ACOS by physician's diagnosis could be significant in predicting future risk of exacerbation.

Original languageEnglish
Pages (from-to)289-298
Number of pages10
JournalTuberculosis and Respiratory Diseases
Volume81
Issue number4
DOIs
StatePublished - Oct 2018

Keywords

  • Asthma
  • Chronic obstructive
  • Phenotype
  • Pulmonary disease

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