Accuracy of a New Algorithm to Identify Asthma–COPD Overlap (ACO) Patients in a Cohort of Patients with Chronic Obstructive Airway Disease

Luis Pérez de Llano, Borja G. Cosío, Marc Miravitlles, Vicente Plaza

Research output: Contribution to journalArticleResearchpeer-review

14 Citations (Scopus)

Abstract

© 2017 SEPAR Objectives: We aimed to characterize the clinical, functional and inflammatory features of patients diagnosed diagnosed with ACO according to a new algorithm and to compare them with those of other chronic obstructive airway disease (COAD) categories (asthma and COPD). Methods: ACO was diagnosed in a cohort of COAD patients in those patients with COPD who were either diagnosed with current asthma or showed significant blood eosinophilia (≥300 cells/μl) and/or a very positive bronchodilator response (>400 ml and >15% in FEV1). Results: Eighty-seven (29.8%) out of 292 patients fulfilled the ACO diagnostic criteria (12.8% asthmatics who smoked <20 pack-years, 100% of asthmatics who smoked ≥20 pack-years, 47.7% of COPD with >200 eosinophils/μl in blood and none with non-eosinophilic COPD). ACO, asthma and COPD patients showed no differences in symptoms or exacerbation rate. Mean pre-bronchodilator FEV1 in ACO and asthma were similar (1741 vs 1771 ml), higher than in COPD (1431 ml, p < 0.05). DLCO was lower in ACO than in asthma (68.1 vs 84.1%) and similar to COPD (64.5%). Mean blood eosinophil count was similar in ACO and asthma (360 vs 305 cells/μl) and higher than in COPD (170 cells/μl). Periostin levels were similar in ACO to COPD (36.6 and 36.5 IU/ml) and lower than in asthma (41.5 IU/ml, p < 0.05), whereas FeNO levels in ACO were intermediate. Conclusion: This algorithm classifies as ACO all smoking asthmatics with non-fully reversible airway obstruction and a considerable proportion of e-COPD patients, highlighting those who can benefit from inhaled corticosteroids.
Original languageEnglish
Pages (from-to)198-204
JournalArchivos de Bronconeumologia
Volume54
Issue number4
DOIs
Publication statusPublished - 1 Apr 2018

Keywords

  • Asthma
  • Asthma-chronic obstructive pulmonary disease overlap
  • Chronic obstructive pulmonary disease

Fingerprint Dive into the research topics of 'Accuracy of a New Algorithm to Identify Asthma–COPD Overlap (ACO) Patients in a Cohort of Patients with Chronic Obstructive Airway Disease'. Together they form a unique fingerprint.

Cite this