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

Title
Increased risk of exacerbation in asthma predominant asthma-chronic obstructive pulmonary disease overlap syndrome
Author
김태형
Keywords
Asthma; Pulmonary Disease; Chronic Obstructive; Phenotype
Issue Date
2018-10
Publisher
TAEHAN KYORHAEK HYOPHOE-KOREAN ACAD TUBERCULOSIS & RESPIRATORY DISEASES
Citation
TUBERCULOSIS AND RESPIRATORY DISEASES, v. 81, no. 4, page. 289-298
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.
URI
https://synapse.koreamed.org/DOIx.php?id=10.4046/trd.2017.0064http://repository.hanyang.ac.kr/handle/20.500.11754/120300
ISSN
1738-3536; 2005-6184
DOI
10.4046/trd.2017.0064
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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