Abstract
Introduction Subjects with asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) share common features of patients with asthma and COPD. Our study was planned to describe the clinical and functional features of subjects with ACO compared to asthma and COPD patients. Subjects and Methods Study subjects who met the inclusion criteria were classified into three different groups: asthma, COPD, and ACO groups. All study subjects underwent clinical examination and biological and functional testing. They were then followed for 6 months to evaluate the response to conventional treatment. Results From March 2015 to March 2017, 76 asthmatic (mean age: 41 ± 22 years), 74 COPD (59 ± 13 years), and 59 ACO (52 ± 14 years) subjects were included. The percentage of subjects with dyspnea on excretion in the ACO group was higher than that in asthma and COPD groups (P < 0.001 and P < 0.05, resp.). Subjects with COPD and ACO had significant airflow limitation (FEV1) compared to asthma (64 ± 17% and 54 ± 14% versus 80 ± 22%; P < 0.01 and P < 0.01, resp.). The levels of FENO in subjects with asthma and ACO were significantly higher than those in subjects with COPD (46 ± 28 ppb and 34 ± 12 ppb versus 15 ± 8 ppb; P < 0.001 and P < 0.001, resp.). VO2 max and 6MWD were improved in study subjects after 6 months of treatment. Increased CANO and AHI > 15/hour had a significant probability of risk for ACO (OR = 33.2, P < 0.001, and OR = 3.4, P < 0.05, resp.). Conclusion Subjects with ACO share the common clinical and functional characteristics of asthma and COPD but are more likely to have sleep apnea. The majority of patients with ACO have a favourable response to combined treatment.
Highlights
Subjects with asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) share common features of patients with asthma and COPD
Subjects with ACO share the common clinical and functional characteristics of asthma and COPD but are more likely to have sleep apnea. e majority of patients with ACO have a favourable response to combined treatment
Subjects more than 18 years old preselected from different centres in Vietnam who came to the Clinical Research Center of Lam Dong Medical College (LMC), Vietnam, for diagnosis and treatment for chronic respiratory diseases were included in this study after signing an Institutional Review Board- (IRB-) approved consent and meeting the inclusion and exclusion criteria. e present study had been approved by the LMC Institutional Review Board
Summary
INCLUSION: Subjects with chronic respiratory symptoms (having one of the following features (A): chronic or recurrent cough or sputum production, dyspnea, wheezing, physician-diagnosed asthma, or COPD, treated with inhaled medications). EVALUATION AFTER 3 MONTHS (i) Clinical examination; control disease (ii) Phlethysmography; DLCO; 6MWT; exhaled NO (iii) Treatment adherence; inhaled treatment technique. EVALUATION AFTER 6 MONTHS (i) Clinical examination; control disease (ii) LFTs; 6MWT; VO2 max; exhaled NO; polysomnography (iii) Treatment adherence; inhaled treatment technique. Compared to patients with asthma and COPD, subjects with ACO have more symptoms, higher rate of acute exacerbations, greater health care consumption, and lower quality of life, suggesting that there is a definite need for further research [8,9,10]. Asian country, such as in Vietnam, seems to be critical. is study describes the clinical and functional characteristics and the therapeutic response of subjects with ACO compared to those with asthma and COPD in a Vietnamese population
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