Clinical Characteristics and Risk of Exacerbations Associated With Different Diagnostic Criteria of Asthma-COPD Overlap

Introduction: There is currently no universally accepted definition of asthma-COPD overlap (ACO). Objective: To compare the prevalence of ACO in patients with asthma or COPD, and to assess their clinical characteristics and the capacity of the different definitions to predict the risk of exacerbatio...

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Autores: Soler-Cataluña JJ, Novella L, Soler C, Nieto ML, Esteban V, Sánchez-Toril F, Miravitlles M
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p5744
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/5744
Access Level:acceso abierto
Palabra clave:Asthma-COPD overlap
COPD
Asthma
Exacerbations
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spelling Clinical Characteristics and Risk of Exacerbations Associated With Different Diagnostic Criteria of Asthma-COPD OverlapSoler-Cataluña JJNovella LSoler CNieto MLEsteban VSánchez-Toril FMiravitlles MAsthma-COPD overlapCOPDAsthmaExacerbationsIntroduction: There is currently no universally accepted definition of asthma-COPD overlap (ACO). Objective: To compare the prevalence of ACO in patients with asthma or COPD, and to assess their clinical characteristics and the capacity of the different definitions to predict the risk of exacerbation. Method: Prospective observational study with a 12-month follow-up in an asthma cohort and a COPD cohort. Four diagnostic criteria were compared: A) the Spanish 2012 consensus; B) the 2016 international consensus; C) the 2017 consensus between the Spanish COPD guidelines (GesEPOC) and GEMA asthma guidelines; and D) the single criterion of >= 300 eosinophils/mu L, proposed by GOLD 2019. The risk of exacerbations was evaluated in each group. Results: A total of 345 patients were included, 233 (67.5%) with COPD and 112 (32.5%) with asthma, aged 63 +/- 14 years, 70.4% men. Fifteen (4.3%) patients met the criteria for ACO according to the criteria described under A above; 30 (8.7%) with the criteria of B; 118 (34.2%) with the criteria of C; and 97 (28.1%), with the D criterion. The ACO-COPD subtype were older, had worse lung function, and an increased risk of exacerbation compared with the ACO-asthma group. Of all the definitions evaluated, those which distinguished a higher risk of exacerbations were the GesEPOC-GEMA consensus and the GOLD proposal. Conclusions: The prevalence of ACO varies enormously depending on the diagnostic criteria used. The ACO population is heterogeneous, and the ACO-COPD subtype is very different from the ACO-asthma subtype. The definitions that include eosinophilia identify ACO patients with a greater risk of exacerbation. (C) 2020 Published by Elsevier Espana, S.L.U. on behalf of SEPAR.ELSEVIER ESPANA SLU2020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/5744ARCHIVOS DE BRONCONEUMOLOGIAISSN: 03002896ISSNe: 15792129reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p57442026-06-11T12:45:17Z
dc.title.none.fl_str_mv Clinical Characteristics and Risk of Exacerbations Associated With Different Diagnostic Criteria of Asthma-COPD Overlap
title Clinical Characteristics and Risk of Exacerbations Associated With Different Diagnostic Criteria of Asthma-COPD Overlap
spellingShingle Clinical Characteristics and Risk of Exacerbations Associated With Different Diagnostic Criteria of Asthma-COPD Overlap
Soler-Cataluña JJ
Asthma-COPD overlap
COPD
Asthma
Exacerbations
title_short Clinical Characteristics and Risk of Exacerbations Associated With Different Diagnostic Criteria of Asthma-COPD Overlap
title_full Clinical Characteristics and Risk of Exacerbations Associated With Different Diagnostic Criteria of Asthma-COPD Overlap
title_fullStr Clinical Characteristics and Risk of Exacerbations Associated With Different Diagnostic Criteria of Asthma-COPD Overlap
title_full_unstemmed Clinical Characteristics and Risk of Exacerbations Associated With Different Diagnostic Criteria of Asthma-COPD Overlap
title_sort Clinical Characteristics and Risk of Exacerbations Associated With Different Diagnostic Criteria of Asthma-COPD Overlap
dc.creator.none.fl_str_mv Soler-Cataluña JJ
Novella L
Soler C
Nieto ML
Esteban V
Sánchez-Toril F
Miravitlles M
author Soler-Cataluña JJ
author_facet Soler-Cataluña JJ
Novella L
Soler C
Nieto ML
Esteban V
Sánchez-Toril F
Miravitlles M
author_role author
author2 Novella L
Soler C
Nieto ML
Esteban V
Sánchez-Toril F
Miravitlles M
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Asthma-COPD overlap
COPD
Asthma
Exacerbations
topic Asthma-COPD overlap
COPD
Asthma
Exacerbations
description Introduction: There is currently no universally accepted definition of asthma-COPD overlap (ACO). Objective: To compare the prevalence of ACO in patients with asthma or COPD, and to assess their clinical characteristics and the capacity of the different definitions to predict the risk of exacerbation. Method: Prospective observational study with a 12-month follow-up in an asthma cohort and a COPD cohort. Four diagnostic criteria were compared: A) the Spanish 2012 consensus; B) the 2016 international consensus; C) the 2017 consensus between the Spanish COPD guidelines (GesEPOC) and GEMA asthma guidelines; and D) the single criterion of >= 300 eosinophils/mu L, proposed by GOLD 2019. The risk of exacerbations was evaluated in each group. Results: A total of 345 patients were included, 233 (67.5%) with COPD and 112 (32.5%) with asthma, aged 63 +/- 14 years, 70.4% men. Fifteen (4.3%) patients met the criteria for ACO according to the criteria described under A above; 30 (8.7%) with the criteria of B; 118 (34.2%) with the criteria of C; and 97 (28.1%), with the D criterion. The ACO-COPD subtype were older, had worse lung function, and an increased risk of exacerbation compared with the ACO-asthma group. Of all the definitions evaluated, those which distinguished a higher risk of exacerbations were the GesEPOC-GEMA consensus and the GOLD proposal. Conclusions: The prevalence of ACO varies enormously depending on the diagnostic criteria used. The ACO population is heterogeneous, and the ACO-COPD subtype is very different from the ACO-asthma subtype. The definitions that include eosinophilia identify ACO patients with a greater risk of exacerbation. (C) 2020 Published by Elsevier Espana, S.L.U. on behalf of SEPAR.
publishDate 2020
dc.date.none.fl_str_mv 2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/5744
url https://fisabio.portalinvestigacion.com/publicaciones/5744
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER ESPANA SLU
publisher.none.fl_str_mv ELSEVIER ESPANA SLU
dc.source.none.fl_str_mv ARCHIVOS DE BRONCONEUMOLOGIA
ISSN: 03002896
ISSNe: 15792129
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
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