Prevalence of Asthma-COPD Overlap in COPD and Severe Asthma Cohorts

2021 ◽  
Author(s):  
Hyonsoo Joo ◽  
So-Young Park ◽  
So Young Park ◽  
Seo Young Park ◽  
Sang-Heon Kim ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Eosinophil Count ◽  
Clinical Manifestations ◽  
Forced Expiratory Volume ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Blood Eosinophil ◽  
Obstructive Pulmonary Disease ◽  
Blood Eosinophil Count ◽  
Bronchodilator Response

Abstract Background: Asthma and chronic obstructive pulmonary disease (COPD) are airway diseases with similar clinical manifestations, despite differences in pathophysiology. Asthma-COPD overlap (ACO) is a condition characterized by overlapping clinical features of both diseases. There have been few reports regarding the prevalence of ACO in COPD and severe asthma cohorts. ACO is heterogeneous; patients can be classified on the basis of phenotype differences. This study was performed to analyze the prevalence of ACO in COPD and severe asthma cohorts. In addition, this study compared baseline characteristics among ACO patients according to phenotype.Methods: Patients with COPD were prospectively enrolled into the Korean COPD subgroup study (KOCOSS) cohort. Patients with severe asthma were prospectively enrolled into the Korean Severe Asthma Registry (KoSAR). ACO was defined in accordance with the updated Spanish criteria. In the COPD cohort, ACO was defined as bronchodilator response (BDR) ≥ 15% and ≥ 400 mL from baseline or blood eosinophil count ≥ 300 cells/μL. In the severe asthma cohort, ACO was defined as age ≥ 35 years, smoking ≥ 10 pack-years, and post-bronchodilator forced expiratory volume in 1 s/forced vital capacity < 0.7. Patients with ACO were divided into four groups according to smoking history (threshold: 20 pack-years) and blood eosinophil count (threshold: 300 cells/μL).Results: The prevalence of ACO significantly differed between the COPD and severe asthma cohorts (19.8% [365/1839] vs. 12.5% [104/832], respectively, P < 0.001). The numbers of patients in each group were as follows: Group A (smoking 10–20 pack-years and blood eosinophil count ≥ 300 cells/μL), 42 (9.1%); Group B (smoking 10–20 pack-years and eosinophil count < 300 cells/μL), 17 (3.7%); Group C (smoking ≥ 20 pack-years and eosinophil count ≥ 300 cells/μL), 341 (73.8%); and Group D (smoking ≥ 20 pack-years and eosinophil count < 300 cells/μL), 62 (13.4%). Age, sex, BDR, comorbidities, and medications significantly differed among the four groups.Conclusion: The prevalence of ACO differed between COPD and severe asthma cohorts. ACO patients can be classified into four phenotype groups, such that each phenotype exhibits distinct characteristics.

scholarly journals New GOLD COPD Guideline 2019: How We Deal with It? (Inhaled Corticosteroid Use and Blood Eosinophil Count)

2021 ◽  
Vol 1 (2) ◽  
pp. 79-87
Author(s):  
Ari Julian Saputra ◽  
Kiki Widyastuti ◽  
Yusup Subagio Sutanto
Keyword(s):  
Eosinophil Count ◽  
Inhaled Corticosteroids ◽  
Low Cost ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Blood Eosinophil ◽  
Obstructive Pulmonary Disease ◽  
Blood Eosinophil Count ◽  
Blood Eosinophils ◽  
Group D

Background: Blood eosinophils may predict response to inhaled corticosteroids (ICS) in chronic obstructive pulmonary disease (COPD), where ICS is recommended in patients at high risk of exacerbations by the Global Initiative for COPD (GOLD) strategy. It can help clinicians to estimate the likelihood of beneficial preventive responses to the addition ICS to regular bronchodilator treatment, and thus can be used as a biomarker in conjunction with clinical assessment when making decisions regarding ICS use. This study aims to compare therapeutic data with blood eosinophil count in COPD patients. Methods: Data were collected from consecutive COPD outpatients in Bukit Asam Medika Hospital starting from March 1st, 2019 until June 30th, 2019 and dr. H. Mohamad Rabain Hospital starting from Oct 1st, 2019 until Dec 27th, 2019. We collected demographics, anthropometrics, smoking history, therapy, dynamic lung volumes, the Medical Research Council scale (MRC), CAT score, and blood eosinophil count. Results: From 57 data collected, 24 (42,1%) patients were having blood eosinophil count ≥300. Patients who have more exacerbation in COPD Group C were 33,3% and 63,2% in COPD Group D. The proportions of ICS-treated COPD Group D patients and blood eosinophil count of <300 and ≥300 was 63,9% and 36,1%, respectively. Conclusion: This study may provide information and characteristic of COPD patient in Indonesia rural area and showed who may have benefit to ICS therapy based on recommendation GOLD COPD 2019. Blood eosinophils counts is a low-cost biomarker and may help clinicians to made decision therapy.

scholarly journals The association between eosinophilic exacerbation and eosinophilic levels in stable COPD

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hye Seon Kang ◽  
Sung Kyoung Kim ◽  
Yong Hyun Kim ◽  
Jin Woo Kim ◽  
Sang Haak Lee ◽  
...  
Keyword(s):  
Eosinophil Count ◽  
Chronic Obstructive ◽  
Blood Eosinophil ◽  
Copd Exacerbation ◽  
Obstructive Pulmonary Disease ◽  
Blood Eosinophil Count ◽  
Acute Exacerbations ◽  
Retrospective Multicenter Study ◽  
Predict Treatment Response ◽  
Eosinophil Counts

Abstract Background Blood eosinophil count may predict treatment response in patients with chronic obstructive pulmonary disease (COPD) during acute exacerbations (AE). However, the ability and thresholds of blood eosinophil counts in stable status to predict eosinophilic AECOPD have not been completely investigated. Methods This was a retrospective multicenter study performed January 2010 to December 2014. COPD subjects hospitalized with exacerbations, were included. Blood samples were obtained at the time of AE and stable disease at outpatient clinic before or after admission. We identified a blood eosinophil count cut-off point at stable COPD, either taken as a percentage or as absolute value, for identification of eosinophilic exacerbation. Results There was significant positive correlation of eosinophil counts between stable COPD and AECOPD. The best cut-off value of blood eosinophil count in stable status for the prediction of eosinophilic COPD exacerbation based on blood eosinophil count ≥ 2% was 300 cells/µL (area under the ROC curve [AUC] 0.614, P = 0.001, 39% sensitivity, 83.8% specificity). When the eosinophilic COPD exacerbation was based on blood eosinophil count ≥ 300 cells/µL, the best cut-off value of blood eosinophil count in stable status for the prediction of eosinophilic COPD exacerbation was also 300 cells/uL (AUC 0.634, P = 0.046, 45.8% sensitivity, 80.9% specificity). Conclusions We demonstrated association between blood eosinophil counts at stable COPD and those with AECOPD. The thresholds of blood counts at stable COPD to predict eosinophilic exacerbations was 300 cells/µL. Further and prospective studies in other populations should validate our results.

scholarly journals The prediction of eosinophilic exacerbation by eosinophil levels stratified in stable COPD

2020 ◽  
Author(s):  
Hye Seon Kang ◽  
Sung Kyoung Kim ◽  
Yong Hyun Kim ◽  
Jin Woo Kim ◽  
Sang Haak Lee ◽  
...  
Keyword(s):  
Eosinophil Count ◽  
Chronic Obstructive ◽  
Blood Eosinophil ◽  
Copd Exacerbation ◽  
Obstructive Pulmonary Disease ◽  
Blood Eosinophil Count ◽  
Acute Exacerbations ◽  
Retrospective Multicenter Study ◽  
Predict Treatment Response ◽  
Eosinophil Counts

Abstract Background Blood eosinophil count may predict treatment response in patients with chronic obstructive pulmonary disease (COPD) during acute exacerbations (AE). However, the ability and thresholds of blood eosinophil counts in stable status to predict eosinophilic AECOPD have not been completely investigated. Methods This was a retrospective multicenter study performed January 2010 to December 2014. COPD subjects hospitalized with exacerbations, were included. Blood samples were obtained at the time of AE and stable disease at outpatient clinic before or after admission. We identified a blood eosinophil count cut-off point at stable COPD, either taken as a percentage or as absolute value, for identification of predicting blood eosinophil count at AECOPD. Results There was significant positive correlation of eosinophil counts between stable COPD and AECOPD. The best cut-off value of blood eosinophil count in stable status for the prediction of eosinophilic COPD exacerbation based on blood eosinophil count ≥ 2% was 300 cells/µL (area under the ROC curve [AUC] 0.614, P = 0.001, 39% sensitivity, 83.8% specificity). When the eosinophilic COPD exacerbation was based on blood eosinophil count ≥ 300 cells/µL, the best cut-off value of blood eosinophil count in stable status for the prediction of eosinophilic COPD exacerbation was also 300 cells/uL (AUC 0.634, P = 0.046, 45.8% sensitivity, 80.9% specificity). Conclusions We demonstrated association between blood eosinophil counts at stable COPD and those with AECOPD. The thresholds of blood counts at stable COPD to predict eosinophilic exacerbations was 300 cells/µL. Further and prospective studies in other populations should validate our results.

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