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May 05, 2013

The COPD-asthma overlap needs greater recognition

 

More attention should be given to patients who have chronic obstructive pulmonary disease (COPD) and concomitant asthma, after a study showed that nearly one-fifth of patients with COPD fall into this subtype.
 
Patients with overlap of the two conditions experienced poorer symptom control, had lower quality of life (QoL), and took part in less physical activity compared with other patients with COPD, despite having similar forced expiratory volume in 1 second (FEV1) values and less exposure to smoking.
 
“Clear diagnostic criteria and management guidelines for this phenotype must be developed and prospectively validated, and this phenotype should be incorporated in phenotype-guided management of COPD,” say authors Marc Miravitlles (Vall d’Hebron University Hospital, Barcelona, Spain) and colleagues.
 
The study included data on 3885 participants aged 40-80 years who were part of the population-based EPI-SCAN study. Overall, 385 participants had COPD, defined as a post-bronchodilator FEV1/forced vital capacity ratio of less than 0.7, of whom 67 (17.4%) had also been diagnosed with asthma.
 
The authors found that patients with overlap COPD-asthma were more likely to be women (55.2 vs 24.2%), to never have smoked (56.7 vs 19.5%), and have a significantly higher body mass index (29.1 vs 27.8 kg/m2) than non-overlap patients. However, spirometry and 6-minute walking test results were similar between the two groups.
 
Read the entire article here.