Prevalence Of asthma-COPD Overlap Syndrome Research Articles

A STUDY ON “PREVALENCE OF COPD OVERLAP IN ASTHMA PATIENTS–HOSPITAL BASED CROSS SECTIONAL STUDY”

BACKGROUND:Asthma- COPD Overlap Syndrome (ACOS) is a recently dened terminology characterized by persistent limitation in airow, which shares features of both Asthma and COPD. ACOS is associated with worse outcomes than either condition alone. MATERIALS AND METHODS: A cross sectional study conducted in Government Thanjavur Medical College Hospital in the department of Internal Medicine between October 2017 and July 2018. The patients attending the asthma clinic and the medicine op for medications were enrolled into the study. Atotal of 80 patients were included. The statistical analyses were performed using Graph pad Prism version 5 software. RESULTS: In this study it was found that 25 % of the study population had a COPD overlap features. Duration of asthma was found to be a single independent factor associated with the development of COPD overlap in asthmatics in the study population. This study views smoking to have an additive effect in the disease pathology. CONCLUSION: The prevalence of ACOS in previously diagnosed Asthma or COPD is more alarmingly increasing. Asthma- COPD overlap is characterised by more frequent exacerbations and complications. There is a critical need to better dene the management and treatment of this syndrome.

The Prevalence of Asthma-COPD Overlap Syndrome in Patients with Obstructive Airway Disease in Kerman, Iran

Background: The coexistence of asthma and chronic obstructive pulmonary disease (COPD) is recognized as asthma–COPD overlap syndrome (ACOS). This study aimed to investigate the prevalence of ACOS and the characteristics of the affected patients in terms of chronic pulmonary airway diseases in the southeastern Iran, Kerman.Methods: This cross-sectional study was conducted in Kerman province, Iran, from March 2017 to March 2018. 295 patients with a history of chronic pulmonary airway diseases including asthma and COPD were enrolled through convenience sampling. Spirometry was performed and forced expiratory volume (FEV1), forced vital capacity (FVC), and FEV1/FVC were calculated. The physician made the final diagnosis according to GOLD/GINA criteria. Chi-square, Fisher’s exact test, t-test, and Mann–Whitney U test were used to compare variables through SPSS version 23.Results: The ACOS prevalence was 36.9% (95% CI: 31.5- 42.7). Asthma patients were younger than ACOS patients (P = 0.001) and they had higher levels of FEV1 (P = 0.02), FEF (P ≤ 0.001), and FEV1/FVC (P ≤ 0.001) before receiving bronchodilator in comparison to ACOS patients. However, COPD patients were older than the ACOS patients (P ≤ 0.001). The lung function in ACOS patients before and after receiving bronchodilators was higher for FEV1 and FVC in COPD patients.Conclusion: The prevalence of ACOS was considerable. The present study showed that gender, age, and BMI could be associated with ACOS. The risk factors underlying ACOS and their impact on the patient’s life quality and treatment costs can be investigated by future studies.

The prevalence of Asthma-Copd Overlap Syndrome In Women Patients With Biomass Fuel Utilizing

Objective: Asthma-chronic obstructive pulmonary disease overlap (ACO) indicates that its characteristics with pulmonary exaggerated reactivity and airflow limitation chronically. We aimed to investigate the differences among women non smoker participants who have asthma, chronic obstructive pulmonary disease (COPD) and ACO with biomass smoke exposure.
 Method: Patients were examined at the outpatient clinic from September 2017 to March 2020. Non-smoker women patients aged ≥40 years, diagnosed with obstructive pulmonary disease were included in the study. pulmonary function tests (PFT), early reversibility testing (bronchodilator test), and sputum eosinophil analysis were performed to all patients.
 Results: A total of 102 patients were included. The mean age was 46.95±9.50 years. In the differential diagnosis, 65 patients (63.7%) had asthma and 37 patients (36.3%) had COPD. Among COPD patients, 10 (27.0%) were diagnosed with ACO. The actual prevalence rates of COPD and ACO were 26.5% and 9.8%, respectively. Poisson regression analysis showed that COPD compared to asthma, while holding the others variable constant in the model, are expected to have 2.976 times greater rate for exacerbations.( IRR, 95%CI ,2.976 (0.687 to 1.494), 5.296 (1.203 to 2.130), P<0.001, Coef. 1.091, 1.667 respectively). Logistic Regression analysis demonstrated that, the count of sputum, blood eosinophil and total IgE results were correlated with the exacerbation times.
 Conclusion: Biomass smoke exposure in the women population is revealed as a significant factor for the diagnosis of ACO.

THE PREVALENCE AND PATIENT CHARACTERISTICS OF ASTHMA-COPD OVERLAP SYNDROME AMONG CHRONIC AIRFLOW LIMITATIONS PATIENTS: HOSPITAL-BASED STUDY

SESSION TITLE: Tuesday Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/22/2019 01:00 PM - 02:00 PM PURPOSE: Distinguishing asthma from COPD can be problematic, particularly in smokers and older adults. Asthma-COPD overlap syndrome (ACOS) is identified by the clinical features that it shares with both asthma and COPD. In epidemiological studies, reported prevalence rates for ACOS have wide range between 15-20% reflects the different criteria that have been used by different investigator for diagnosing ACOS. Moreover, there is still no data about ACOS prevalence in Indonesia. Therefore, we aimed to determine prevalence and patient characteristics of ACOS among chronic airflow limitations patients in Indonesia. METHODS: This hospital-based cross sectional study conducted in asthma and COPD patients. Patients were male or female, 40 years or older and able to perform a spirometry and bronchodilator test. ACOS diagnosis was made using modified GINA/GOLD 2017 criteria which at least three clinical features that support asthma and COPD. RESULTS: This study showed that ACOS prevalence from 60 subjects was 58.3%. Characteristic patients identified as having ACOS had mean age of 61.5±10.2 year, median Brinkman index 0.5, mean BMI of 24.9±3.8% kg/m2 and the most common symptoms were shortness of breath (88.7%) and wheezing (77.1%). Spirometry result showed better lung function with variability was 10.1% and increase in forced expiratory volume in 1 second (FEV1) 158.3±97.2 ml after bronchodilator test. Chest radiograph from ACOS patient showed 48.6% had severe hyperinflamation. CONCLUSIONS: The prevalence of ACOS was high in hospital based using GINA/GOLD criteria among asthma and COPD patients. To manage ACOS patients effectively it is necessary to identify it accurately. CLINICAL IMPLICATIONS: This results may have an clinical implication on the early identification of ACOS and to manage patients for the most appropriate therapy. DISCLOSURES: No relevant relationships by Triya Damayanti, source=Web Response No relevant relationships by Rania Imaniar, source=Web Response no disclosure on file for Faisal Yunus

Identification and distribution of COPD phenotypes in clinical practice according to Spanish COPD Guidelines: the FENEPOC study.

BackgroundThe Spanish Guidelines for COPD (GesEPOC) describe four clinical phenotypes: non-exacerbator (NE), asthma-COPD overlap syndrome (ACO), frequent exacerbator with emphysema (EE), and exacerbator with chronic bronchitis (ECB). The objective of this study was to determine the frequency of COPD phenotypes, their clinical characteristics, and the availability of diagnostic tools to classify COPD phenotypes in clinical practice.Materials and methodsThis study was an epidemiological, cross-sectional, and multi-centered study. Patients ≥40 years old with a post-bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity ratio of <0.7 and who were smokers or former smokers (with at least 10 pack-years) were included. The availability of diagnostic tools to classify COPD phenotypes was assessed by an ad hoc questionnaire.ResultsA total of 647 patients (294 primary care [PC], 353 pulmonology centers) were included. Most patients were male (80.8%), with a mean age (SD) of 68.2 (9.2) years, mean post-bronchodilator FEV1 was 53.2% (18.9%) and they suffered a mean of 2.2 (2.1) exacerbations in the last year. NE was the most frequent phenotype (47.5%) found, followed by ECB (29.1%), EE (17.0%), and ACO (6.5%). Significant differences between the four phenotypes were found regarding age; sex; body mass index; FEV1; body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE)/body mass index, airflow obstruction, dyspnea and exacerbations (BODEx) index; modified Medical Research Council dyspnea scale; respiratory symptoms; comorbidi-ties; hospitalizations; and exacerbations in the last year. Physicians considered that >80% of the diagnostic tools needed to classify COPD phenotypes were available, with the exception of computed tomography (26.9%) and carbon monoxide transfer test (13.5%) in PC, and sputum eosinophilia count in PC and pulmonology centers (40.4% and 49.4%, respectively).ConclusionIn Spanish clinical practice, almost half of the patients with COPD presented with NE phenotype. The prevalence of ACO according to the Spanish consensus definition was very low. In general, physicians indicated that they had the necessary tools for diagnosing COPD phenotypes.

Prevalence and characteristics of asthma-COPD overlap syndrome identified by a stepwise approach.

Background and objectiveThere is increasing recognition of asthma–COPD overlap syndrome (ACOS), which shares some features of both asthma and COPD; however, the prevalence and characteristics of ACOS are not well understood. The aim of this study was to investigate the prevalence of ACOS among patients with COPD and its characteristics using a stepwise approach as stated in the recent report of the Global Initiative for Asthma (GINA) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).MethodsThis multicenter, cross-sectional, observational study enrolled outpatients who were receiving medical treatment for COPD. Clinical data, including spirometry results, were retrieved from medical records. For symptom assessment, patients were asked to complete the Clinical COPD questionnaire and the modified British Medical Research Council questionnaire.ResultsOf the 1,008 patients analyzed, 167 (16.6%) had syndromic features of ACOS. Of the total number of patients, 93 and 42 (9.2% and 4.2%) also had a predefined clinical variability of ≥12%/≥200 mL and ≥12%/≥400 mL in forced expiratory volume in 1 second (FEV1), respectively, and therefore were identified as having ACOS. Conversely, the number of patients who had either syndromic or spirometric feature of ACOS was 595 (59.0%, ≥12%/≥200 mL FEV1 clinical variability), and 328 patients (32.5%, ≥12%/≥400 mL FEV1 clinical variability) had both the features. Patients identified as having ACOS were of significantly younger age, had a shorter duration of COPD, lower number of pack-years, better lung function, milder dyspnea symptoms, and higher peripheral blood eosinophil values compared with patients with COPD alone. The rate of exacerbations in the previous year was not significantly different between the ACOS and COPD groups.ConclusionUsing a stepwise approach, as stated in the GINA/GOLD report, the proportions of patients identified as having ACOS were found to be 9.2% and 4.2% (depending on the FEV1 variability cutoff used) among the 1,008 outpatients medically treated for COPD in a real-life clinical setting.

Prevalence of Asthma-COPD Overlap Syndrome (ACOS) in Patients Previously Diagnosed as COPD in Ilorin, Nigeria

Prevalence of Asthma-COPD Overlap Syndrome (ACOS) in Patients Previously Diagnosed as COPD in Ilorin, Nigeria

Comorbidome, Pattern, and Impact of Asthma-COPD Overlap Syndrome in Real Life.

Asthma-COPD overlap syndrome (ACOS) has been described and acknowledged as a distinct clinical entity; however, its characteristics in daily clinical practice are largely unknown. The aim of this study was to identify the prevalence of ACOS in the real-life population, its pattern of comorbidities, and its impact on hospitalization risk. Data for this retrospective cohort study were extracted from the Majorca Real-Life Investigation in COPD and Asthma cohort, including primary care, hospitalization, and pharmacy data from the Balearic Islands, Spain. Patients who had received a physician-confirmed diagnosis of both asthma and COPD were identified as having ACOS and compared with a COPD-only population. In subanalyses, more stringent diagnostic criteria (Global Initiative for Asthma-Global Initiative for Chronic Obstructive Lung Disease) were applied. The pattern and impact of comorbidities on all-cause hospitalization were compared by multivariate logistic regression. In total, 5,093 patients with ACOS (prevalence, 5.55 per 1,000 inhabitants) were compared with 22,778 patients with COPD (30.40 per 1,000 inhabitants). Patients with ACOS were more frequently female (53.4%) than were patients with COPD (30.8%), younger (ACOS, 64.0 years; COPD, 65.8 years), and differed by nonsmoking status (ACOS, 41.4%; COPD, 22.1%) (all, P < .001). In adjusted analyses, allergic rhinitis (OR, 1.81; 95% CI, 1.63-2.00), anxiety (OR, 1.18; 95% CI, 1.10-1.27), gastroesophageal reflux disease (OR, 1.18; 95% CI, 1.04-1.33), and osteoporosis (OR, 1.14; 95% CI, 1.04-1.26) were more frequent in ACOS than COPD. In contrast, chronic kidney disease (OR, 0.79; 95% CI, 0.66-0.95) and ischemic heart disease (OR, 0.88; 95% CI, 0.79-0.98) were less frequent. In patients with ACOS, cardiovascular diseases showed the strongest association with hospitalization. ACOS is prevalent in the general population, and it affects to a large extent females with less smoking exposure compared with patients with COPD only. Cardiovascular comorbidities in particular contribute most to overall hospitalization risk of patients with ACOS.