Defining the Asthma-COPD overlap syndrome in a COPD cohort.
Chest. 2015 Aug 20;
Authors: Cosio BG, Soriano JB, López-Campos JL, Calle-Rubio M, Soler-Cataluna JJ, de-Torres JP, Marín JM, Martínez-Gonzalez C, de Lucas P, Mir I, Peces-Barba G, Feu-Collado N, Solanes I, Alfageme I, Casanova C
Abstract
Background: 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.
Methods: In order to identify patients with ACOS, a cohort of well-characterized patients with COPD and up to one-year follow-up was analyzed. We evaluated the presence of specific characteristics associated to asthma in this COPD cohort, divided in major criteria (bronchodilator test greater than 400 ml and 15% and past medical history of asthma) and minor criteria (blood eosinophils greater than 5%, IgE>100 UI/ml, or two separate bronchodilator tests greater than 200 ml and 12%). We defined ACOS by the presence of one major criterion or two minor criteria. Baseline characteristics, health status (CAT), BODE index, rate of exacerbations and mortality up to one year of follow-up were compared between patients with and without criteria for ACOS.
Results: Out of 831 COPD patients included,125 (15%) fulfilled the criteria for ACOS, and 98.4% of them sustained these criteria after one year. Patients with ACOS were predominantly male (81.6%), with symptomatic mild to moderate disease (67%), and receiving inhaled corticosteroids (63.2%). There were no significant differences in baseline characteristics, and only survival was worse in non-ACOS COPD patients after one-year of follow-up (p <0.05).
Conclusions: The proposed ACOS criteria are present in 15% of a cohort of COPD patients and these patients show better one-year prognosis than clinically similar COPD patients with no ACOS criteria.
ClinicalTrials.gov Identifier: NCT01122758.
PMID: 26291753 [PubMed - as supplied by publisher]