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Favorable longitudinal change of lung function in patients with asthma-COPD overlap from a COPD cohort

Title
Favorable longitudinal change of lung function in patients with asthma-COPD overlap from a COPD cohort
Author
이현
Keywords
Asthma; Chronic obstructive pulmonary disease; Lung function
Issue Date
2018-03
Publisher
BMC
Citation
RESPIRATORY RESEARCH, v. 19, Article no. UNSP 36
Abstract
Background: 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.Methods: 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/mu L. Lung function decline was compared using a linear mixed effects model for longitudinal data with random intercept and random slope.Results: 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 beta 2-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.Conclusion: Patients with ACO showed favorable longitudinal changes in lung function compared to COPD patients over a median follow-up of 5.8 years.
URI
https://respiratory-research.biomedcentral.com/articles/10.1186/s12931-018-0737-8https://repository.hanyang.ac.kr/handle/20.500.11754/117991
ISSN
1465-993X; 1465-9921
DOI
10.1186/s12931-018-0737-8
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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