Defining asthmaxe2x80x93COPD overlap syndrome: a population-based study

[摘要] Asthmaxe2x80x93chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) seems an important clinical phenotype; but multiple definitions have been proposed. This study's objectives were to assess the effect of different ACOS definitions on prevalence; patient characteristics and exacerbations.5675 individuals aged 45xe2x80x9365xe2x80x85years; with 846 asthma/COPD patients; were included in the Netherlands Epidemiology of Obesity study between 2008 and 2012; and followed-up for a median of 1.8xe2x80x85years. ACOS was defined by recent consensus criteria and five other definitions; based on registry; questionnaires and lung function.Prevalence of ACOS in the asthma/COPD population ranged between 4.4% and 38.3%; depending on the definition used. Agreement between registry-based and self-reported ACOS was 0.04 and 0.41 when lung function (forced expiratory volume in 1xe2x80x85s (FEV1)/forced vital capacity (FVC) <0.7) was added. With registry or self-report defined ACOS; only 51% and 33% had FEV1/FVC <0.7. Patient characteristics were similar; but asthma duration was longer with self-reported compared with registry-based ACOS (mean difference 22xe2x80x85years (95% CI 12xe2x80x9333)). Exacerbation risk was highest with registry-based ACOS compared with asthma (adjusted incidence rate ratio 1.6 (95% CI 1.2xe2x80x932.1)).This study adds important knowledge about agreement between ACOS definitions and their relation with exacerbations. Given the low agreement; differences in prevalence; patient characteristics and risk of exacerbations; consensus about ACOS definition in different care settings is urgently needed.

[学科分类] 呼吸医学